Accounts Receivable Specialist

Accounts Receivable Specialist

Position Summary

The Accounts Receivable Specialist role and responsibilities include : monitoring all aspects of the

collection of outstanding debts owed to the health system including following up directly with

commercial and governmental payers to resolve claim issues and secure appropriate and timely

reimbursement, resolve missing and unresolved payment issues, and monitor overdue accounts,

Identify and analyze denials and payment variances and takes action to resolve

accounts including drafting and submitting technical appeals. In addition, the AR specialist is the

subject matter expert for all billing staff regarding insurance payer billing procedures.

Primary Position Responsibilities

Maintains a complete understanding of the appropriate account follow-up resolution protocols and

required software programs. Utilizes all software systems in accordance with Patient Account

protocols, and addresses account write-offs in accordance with Hunterdon’s Account Adjustment

Policy and Procedures.

Develops and maintains a working knowledge of all governmental and non-governmental payer

contractual requirements including CMS guidelines, Medicaid Guidelines, and Hunterdon’s

private payer contracts.

Responsible for managing tasking queue in accordance with daily, weekly, monthly, quarterly,

and annual tasks to resolve all accounts within defined payor guidelines and meeting or

exceeding productivity and quality standards and goals as defined by the Business Office

Management Team.

Responsible for reviewing and taking action on aged accounts receivables to include following up

with payers to ensure timely resolution of all outstanding claims via phone, emails, fax, or payer

portals. Responsible for identifying and correcting medical billing errors, initiating required follow-

up actions, and submitting or resubmitting claims to third-party insurance carriers and

governmental payers in accordance with filing guidelines.

Responsible for creating evidence to dispute denied claims based on payer reimbursement rules

when claims are erroneously denied through investigating root cause of denial, compiling of data

to support the overturning of a denial, and creating the appeal documents, as well as following

through on communication with third-party payer to complete the recovery of denied funds.

Responsible for providing support to billers and patient account representatives when an

explanation of patient responsibility is necessary.

Responsible for reviewing account information to identify and analyze trends involving

preventable root cause issues and payer denials. Responsible for communicating identified

trends and issues to Business Office leadership and will perform special projects as needed.

Qualifications

Minimum Education : Required :

• High School Diploma or Equivalent

Preferred :

Minimum Years of Experience (Amount, Type and Variation) :

Required :

Physician / Professional Billing Experience : 3+ years required experience in

insurance payer contracts, submitting appeals, and a complete understanding of

insurance payer’s explanation of benefits and payer reimbursement rules.

Preferred :

License, Registry or Certification :

Required :

Preferred :

Knowledge, Skills and / or Abilities :

Required :

Preferred :

Hunterdon Health is committed to providing a competitive benefit package to our employees. Benefit offerings vary based on status and may include but not be limited to medical, dental, vision, family forming, paid time off, tuition reimbursement, and retirement savings.

The hiring range listed is the potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement. When determining an applicant’s hourly rate and / or base salary, several factors may be considered as applicable (e.g., years of relevant experience, education, internal equity, and specialty).

PI5f518518ef28-30511-38359919