Accounts Receivable (AR) Specialist
Miami (Kendall), FL
Seeking an Accounts Receivables (AR) Specialist for an excellent opportunity in the Miami, FL area. This role will be primarily responsible for providing AR/follow up including denial management support to collect on outstanding accounts receivables.
The AR Specialist will also comply with payer filing deadlines by utilizing all available resources to resolve held claims, assures all known regulatory, contractual, compliance, and guidelines are adhered to with regards to claim billing processes.
Some responsibilities include:
- Utilizes hospital-based applications/databases to verify/review patient registration or work all general levels of assigned tasks to ensure accuracy, support claims processing and meet productivity standards.
- Follows up with appropriate parties for claim data resolution and notates the system with updates throughout each step in the process.
- Assures and maximizes proper use of tools to resolve open Accounts Receivable.
- Reviews claims data and supporting documentation submitted for billing to ensure appropriate coding and billing (i.e. diagnosis and CPT codes). Works non-surgical/clinical denials.
- Prepares Appeal letters for (non-surgical, clinical) denied claims by accessing specific payer appeal forms. Optimizes appeals capabilities and tracks the resolution. Submits medical documentation abying by payer/HIPPA guidelines.
- Considers our payer contracts when working denials, addressing payment matters, and incorporating billing guidelines. Reports any provider credentialing and payer-related contractual matters to appropriate team.
- Identifies any issues affecting reimbursement and escalates to the appropriate leadership chain.
- Remains current with changes in the health care industry by participating in continuing education courses. Stays abreast of CPT-4, HCPCS, ICD-10 and Revenue Code updates as they pertain to the appropriateness on the bill.
- Uses Encoder and NCCI guidelines for resolution of physician claims. Understand payer’s specific billing, coding guidelines.
Interested? APPLY DIRECTLY NOW or give us a call at (Dade: 305-595-3800 / Broward: 954-437-0070) Questions about this role or others? Email firstname.lastname@example.org
*CAREERXCHANGE® is an equal opportunity employer. We will present the most qualified candidates to our clients based on the skills required to perform the job. For additional opportunities please visit www.careerxchange.com.
- Excellent verbal and written communication skills, including ability to effectively communicate with internal and external customers
- Excellent computer proficiency (MS Office – Word, Excel and Outlook)
- Minimum 2-3 years of Physician Billing and AR management experience
- Knowledge of physician billing, regulatory and compliance guidelines
- Knowledge of ICD-10, HCPCS, CPT-4 and modifiers
- Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service
- Ability to work independent and carry out completion of workload
- Associate degree (preferred)
- CCA, CCS or CCS-P certification or any billing/coding certification (Preferred)