Accounts Receivable Specialist
Overview:
Position Summary: Perform diverse billing, collections, accounting, and administrative duties to maintain, bill, and
collect patients’ and residents’ accounts and receivables. Services billed include hospital LTCH(Long Term Acute Care), long term care, skilled nursing, outpatient clinic and therapy.
Insurances billed include Medicare, Medicaid, managed care, and commercial primary and
supplemental plans. Duties include account set-up, maintenance, and management, claim
preparation, submission, and collection to industry standards utilizing Meditech hospital
information system and paper and electronic claims processing to payors, collections, resolution
of issues, and streamlining and improvement of systems and processes. Requirements include 5
years plus related experience, proficiency with PCs and systems, analysis and basic math skills, and excellent attention to detail. Experience with Medicare, Medicaid, third party billing andcollections, and the Meditech Expanse information system, is preferred.
Responsibilities:
Ongoing account management: Monitor accounts for changes and maintain the accuracyof insurance payors in Meditech.
Ongoing billing and collections: Prepare and submit daily and monthly billing and claims
submission to insurances for all service venues (Inpatient LTC, MACU (Medical Acute CareUnit), SNF (Skilled Nursing Facility), Outpatient Clinics and Therapy.
Ongoing billing and collection: Interact with insurance company staffs to resolve eligibility
and coverage issues; utilize online sites and systems of Insurance Companies to automateand streamline the submission, management, and payment of claims.
Ongoing Billing and collections: Obtain needed claim information from systems and other
departments such as Admissions, Health Information Management, Nursing, Therapies, and other ancillary areas to prepare or correct claims. Use systems and technologies tomanage flow of information and identify any issues with processes. Coordinate with
Fiscal staff, Information Technology, and other departments to identify and pursue
opportunities to improve and streamline information flow and efficiency of collections.
Ongoing billing and collections: Following payment by Medicare, Medicaid andCommercial bill; Collect supplemental insurance and Medicaid crossover claims.
Ongoing Billing and collections: Follow up on all claims for review of suspended or denied
claims, correct and resubmit.
Ongoing Billing and collections: Maintain tickler file and accurate notes in Meditech on
follow up activity, maintain systems to manage status and identify issues requiring followup or management attention.
Ongoing Billing and collections: Collect each claim and account to bring to zero balance
and meet collection and cash flow targets, identifying any issues and potentialopportunities for improved processes.
Ongoing Billing and collections: Review and work Accounts Receivable Trial Balance and
account aging to identify, analyze, and resolve unpaid or underpaid claims, determiningreasons and taking appropriate steps to resolve the payment issues.
Ongoing Billing and collections: Process, post and analyze checks and electronic
remittances from patients, and insurances, identifying and resolving denials anddifferences between expected and actual payment.
Ongoing Billing and collections: Manage and reconcile cash receipts and balance to cash
journal. Other related duties as required.
Required Qualifications:
5 + years of related experience required. Proficiency in PC/Excel/Word, basic math skills, attention to detail, analytic ability, organization skills, and maturity are required
Health care hospital billing experience required. Meditech Expanse systems experiencepreferred. Medicare, Medicaid, Third Party billing and collections experience required.
Preferred Qualifications:
MT Expanse and Waystar Billing software experience