A/R Specialist I

Position Summary: 

The Accounts Receivable Specialist I is responsible for managing and processing billing, and collections for Medicaid, private insurance, other third-party payers, and self-pay accounts. The A/R Specialist I is also responsible for accurately applying payments, reconciling accounts, and ensuring timely payment posting. This role requires an understanding of medical billing, claims and remittance processing, and the associated software applications.

PAY: $23-$25/hr.

Essential Responsibilities: 

· Generate and submit claims and invoices to insurers, third-party payers, and clients, ensuring accuracy and completeness of submissions.

· Verify and maintain data related to client demographics, insurance coverage, benefits, and authorizations. Maintain up-to-date information on payers’ billing requirements and covered services.

· Research and resolve claim denials and other issues impeding reimbursement for billed services. Resolve post-payment inquiries, audits, refunds, and recoupment requests as needed.

· Develop and monitor cash flow projections for all assigned areas of responsibility.

· Maintain effective communications within the Agency, clients, third-party payers, and other external organizations to ensure that billing is accurate, timely, and well-documented.

· Report resolved and unresolved charges, status and expected turnaround times for outstanding issues, and projected incomes and adjustments. Report on cash receipts and GL activities as appropriate.

· Collect and retain documentation related to A/R activities as appropriate.

· Prioritize responsibilities and work independently with minimal supervision, in electronic and paper formats.

· Maintain patient confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).

· Comply with all agency policies.

· Cash management: Receive cash/check/digital payments and maintain assets securely. Prepare cash receipts log and deposit listings. Make bank deposits as needed.

· Assist the Revenue Cycle Manager with special projects 

· Perform other duties as required

Requirements

Qualifications: 

Education and Experience

• Associates Degree and 1 year experience with accounts receivable and/or benefits verification in a medical or developmental services setting preferred.
• High school diploma or GED 
• 3 years of experience in Accounts Receivable with an emphasis on healthcare billing, 
• Valid Driver's License
• Auto Insurance policy with minimum policy coverage - $100,000/$300,000

Skills and Abilities

• Proficiency with software applications including, but not limited to, Microsoft Office Suite and database systems. Experience with Excel is highly weighted.
• Proven understanding of accounting cycle of accounts receivable, from generation and recording of revenues to collections and cash projections.
• Understanding of medical billing and claims including but not limited to CPT, HCPCS, ICD-10, CMS-1500, and EDI transmissions.
• Experience with electronic medical records (EMR) and medical billing software.
• High attention to detail and an analytical mindset.
• Ability to perform assigned functions with a high degree of accuracy and with minimal supervision.
• Familiarity with government benefits programs (Medicaid/Medicare, Social Security, etc.) preferred.
• Ability to work independently, and as part of a team.
• This position requires working in the finance office.