Accounts Receivable Specialist

Accounts Receivable Specialist

With 150+ locations in 17 states, QualDerm Partners is the largest multi-state female-founded and owned dermatology network in the U.S. At QualDerm Partners, we are united in our purpose : to educate, protect, and care for your skin. We are committed to bringing you the very best in comprehensive skin care so that you can achieve a confident, healthier, and more beautiful you!

Our mission is to educate communities and healthcare professionals about the importance of skin health; including skin cancer prevention, risk factors and how to achieve healthy skin through annual skin exams and dermatologic care. We strive to provide the latest proven, proactive and comprehensive dermatologic care to populations in the expanding geographies we serve by making high-quality skin care timelier and more accessible all while creating a rewarding work environment for our providers and employees.

Position Summary

This position works with a professional team of physicians and other staff who are trained in the medical and surgical specialty of dermatology with the purpose to be patient focused with the objective of delivering superior patient care and ensuring a positive patient experience and outcome.

The Accounts Receivable Specialist is responsible for all day-to-day billing, claims issues, denials and follow-up for their assigned region / locations. Position proactively researches, identifies, and rectifies any circumstance affecting delayed submission or payment of accounts. Position communicates accounts receivable issues proactively to management to ensure compliance and accuracy. Position performs various administrative and clerical duties needed to support revenue cycle functions as needed. Position reports to the Manager, Accounts Receivable and / or Senior Director, Credentialing and Revenue Cycle.

Essential Responsibilities

• Ability to identify the cause of claim denials and resolve them, with minimal assistance.
• Analyze problems and report trends related to denials and payer trends.
• Follow up on unpaid claims within standard billing cycle timeframe.
• Prepare and submit corrected / replacement claims, reconsiderations, appeals, medical documentation and other necessary documents to payers via fax, provider portals, etc.
• Make outbound calls to payers to resolve claims and payment issues.
• Ensure the patient's medical information is accurate and up to date.
• Meets productivity requirements as established by organization and external benchmarks.
• Provides necessary reporting and communication of any accounts receivable issues directly to the team lead.
• Effectively uses billing system to document patient accounts using proper grammar, spelling, and syntax.
• Provide team lead with administrative assistance when needed including assisting with internal / external audits.
• Maintains current knowledge in regards policies and guidelines for all payers.
• Adheres to Code of Conduct and Mission & Values Statement.
• In addition to the above job responsibilities, other duties and projects may be assigned.