CommUnityCare Health Centers ยท 12 hours ago
Accounts Receivable Specialist (REMOTE)
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Responsibilities
Contact insurance carriers on a daily basis to follow up on/collect past due amounts on outstanding medical claims regarding denials or benefit changes.
Maintain an accurate, up to date aging of assigned accounts including AR analysis and follow up.
Keep educated on billing and medical policies for all payers.
Have a working knowledge of In and Out of Network reimbursement processes/methodologies.
Create and follow up on appeals needed to protest denials or incorrect payments.
Review complex denials/tasks assigned by the payment posting team and resolve accordingly including reviewing refund requests, disputes and appeal as necessary.
Work across all RCM departments to get issues related to claims payment resolved.
Uphold and ensure compliance and attention to all company policies and procedures as well as the overall mission and values of the organization.
Work with AR Supervisor to review/resolve open accounts as assigned.
Perform other duties as assigned.
Qualification
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Required
High School Diploma or GED
3 years of experience managing Accounts Receivable and performing direct follow up with payers.
1 year experience communicating effectively, both orally and in writing, with insurance payers and internal company communications.
3 years working with medical terminology, ICD10, CPT, HCPCs coding and HIPAA requirements.
2 years of experience with data processing and analytical skills, proficiency in Excel and Microsoft Office Suite as well as medical practice management software and electronic medical records.
3 years of experience working with commercial, government and state insurance payers and their reimbursement policies and procedures.
3 years' experience working complex insurance issues, including assigning correct payer, EOB adjustments and refunds to accounts.
Company
CommUnityCare Health Centers
CommUnityCare Health Centers is a not-for-profit 501(c) (3) corporation providing primary care health services to the medically underserved.