Advanced Medical Solutions is seeking a full-time professional to join our team as an Accounts Receivable Specialist. Advanced Medical Solutions is a leading provider of quality durable medical products (DME).
Responsible for follow-up of accounts receivable including analyzing, researching and resolving unpaid claim, while providing excellent customer service. Individual must prioritize workflow and ensure Advanced Medical Solutions receives accurate and timely reimbursement.
- Review unpaid claims and research reasons for delay
- Initiate collection follow-up of unpaid or denied claims with the appropriate payer
- Research appeal and resolve claim rejections, underpayments and denials with payers
- Process appeals by gathering information and resubmitting claims
- Communicate payment or denial trending that impact revenue to leadership
- Develop and maintain positive working relationships with team members and payer representatives
- Contact insurance companies to work out any discrepancies and get the claims paid
- Process any adjustments as needed
- Obtains authorization from Work Comp and Commercial Insurance Carriers (insurance verification)
- Prepare and submit claims to insurance carriers on a CMS 1500 form
- Post insurance carrier’s remittance advice/explanation of benefits
- Processes Medical Records workflow
- Faxes/Mails out Physician orders for signature
- Comply with requests for copies of patients’ medical records from patients and other persons such as physician’s, attorneys, and insurance companies following departmental policies to safeguard patient confidentiality
- Demonstrates knowledge of, and supports, mission, vision, standards, policies and procedures, operating instructions.
- Performs other duties as assigned.
- High school diploma or equivalent required
- 3+ years' experience with account follow up and authorizations, preferably in a healthcare environment
- Excellent verbal, written, and social skills
- Ability to work overtime if/when needed
- Strong knowledge of explanation of benefits (EOB's)
- Coursework in insurance billing (i.e. Medicare, Medicaid, private insurance companies), data processing, and medical terminology or equivalent experience necessary.
- Bilingual (preferred)
- Medical, Dental, and Vision insurance offered