Accounts Receivable Specialist

Job Responsibilities:

• Communicate with Payers: Contact payer hotlines for inquiries, clarifications, and the status of claims. Display professionalism and efficiency in all interactions to maintain positive relationships
• Investigate Claim Denials: Proactively investigate the reasons behind claim denials, analyze the information gathered, and develop effective solutions to ensure claim payments
• Manage Claim Adjustments: Resubmit claims, request reprocessing, send corrected claims, and / or create appeals as needed, based on analysis and investigation results
• Follow Up on Outstanding Claims: Diligently and promptly follow up on any open and unpaid claim until the Accounts Receivable list is cleared up, preventing untimely resubmission or appeal
• Maintain the Accounts Receivable System: Regularly update the Accounts Receivable system with clear, comprehensive notes to track progress and facilitate efficient claim management
• Collections of Aging Accounts

Qualifications:

• Experience using PracticeSuite software for more than one (1) year
• At least 3 years’ experience in an accounts receivable role, with a focus on healthcare claims management
• Strong communication skills, both verbal and written, for effective liaison with payers and internal stakeholders
• Proven analytical and problem-solving skills, with the ability to analyze claim denials and devise effective resolutions
• Attention to detail and high levels of accuracy in all tasks
• Ability to work effectively with minimum supervision and manage multiple priorities