Experienced A/R specialist needed

Experienced A/R specialist needed

18 Oct 2024
Oregon, Portland, 97201 Portland USA

Experienced A/R specialist needed

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Advanced Pain Management Center opened its doors in 2000 and has served as a pain management resource for the community and healthcare providers since that time. We currently have an opening for a full-time person experienced in charge posting, patient collection and insurance A/R follow up. This person would want to work in a team oriented environment but would do well working independently within that paradigm.

Description: The purpose of this position is to ensure accurate, compliant, and timely follow up on patient outstanding balances, denied insurance claims as well as unpaid insurance claims. This may include accurate and timely identification and completion of registration, billing, payment posting, contractual write-offs, adjustments, follow-up, and collection of unpaid accounts, per state and federal insurance regulations.

Essential Functions:

Review line items in the on-line system to ensure a correct patient balance.

Verify patient demographics and insurance coverage.

Follow-up with all payers on accounts receivable to ensure prompt and accurate reimbursement, per insurance guidelines.

Submit requests for adjustments, ABN's, appeals, credit balances, and refunds.

Reconcile accounts by determining the correct insurance and patient responsibility through interpretations of payment and denial codes on the explanation of benefits sent by payer.

Document in account notes reasons for billing delays and actions taken.

Review and correct account discrepancies.

Review patient concerns and/or complaints regarding their bill and resolve in collaboration with Administrator.

Review and resolve non-covered charges according to procedures, and review and write-off charges that are not appropriate.

Perform other duties as requested, consistent with job description.

This job description is not all encompassing.

Basic Qualifications:

One (1) year of experience in medical billing and/or patient accounting.

Extensive computer and telephone experience.

High school diploma or GED equivalent (required at time of hire).

Type/keyboard 20 wpm.

Basic knowledge of all aspects of UB-04 and/or CMS 1500 fields and requirements.

Working knowledge of Excel and other business software.

Working knowledge and application of medical terminology, standard billing codes.

Knowledge of state and federal insurance regulations.

Working knowledge of insurance regulations, as they pertain to collection issues.

Basic knowledge of accounting principles.

Knowledge of telephone collection techniques.

Excellent verbal and written communication skills.

Problem solving, listening and conflict resolution skills.

Ability to communicate and negotiate effectively with customers and third party payers.

Excellent organization skills.

Detail oriented with organizational skills which involve the ability to prioritize and manage workflow, to produce high quality work, to work independently with minimal supervision and the ability to use good judgment.

Experience with pain management procedures and coding preferred.

Experience with Athena 1 preferred.

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