The Specialist Accounts Receivable is responsible for accurate and timely Insurance claims error resolution, submission, insurance follow-up and accounts receivable resolution for assigned payers, aging and/or patients. The Specialist is accountable for resolving open claims, appealing denials, aged claims resolution, and special accounts receivable projects. The Specialist adheres to government regulations, payer contracts, and insurance guidelines when performing edit resolution, insurance follow-up, denial management, and appealing claims. The Specialist is a key front-line contributor to the Revenue Cycle identifying and reporting inefficiencies and opportunities that enhance revenue flow, decrease denials, and minimize write-offs.
Education and Experience:
· Bachelor’s Degree in business, healthcare, or related field preferred.
· 4+ years-experience with professional CMS1500 insurance follow-up, payer denials, and insurance appeals
· 4+ years related experience in a business office on a revenue cycle team.