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). 

JOB DESCRIPTION:

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.

RESPONSIBILITIES:

• 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.

REQUIREMENTS

• 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)

JOB PERKS

• Medical, Dental, and Vision insurance offered
• 401(K)