This position is located at the Birmingham Business Office
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** Summary: **Under general supervision, an AR Account Follow-Up Specialist is responsible for account follow-up for all assigned accounts, resolving billing problems and answering patient inquiries. Uses collection techniques to keep accounts receivable current including monitoring for delinquent payments. The Account Follow-Up Specialist will review insurance claims and take the appropriate action, including completion of submissions, reconsiderations, appeals, or re-working denials, to ensure payment is received timely.
Essential Duties and Responsibilities:
Performs audits of patient accounts to ensure accuracy and timely payment.
Reviews account aging monthly and reports inconsistencies and correct errors as appropriate.
Follows up on insurance billing to ensure timely receipt of payments.
Demonstrates the ability to deal with patients and insurance companies regarding sensitive financial matters and recapture unpaid balances.
Receives and resolves patient billing complaints and questions; initiates adjustments as necessary; follows up on all zero payment explanations of benefits and exercises all options to obtain claim payments.
Reviews credit balance reports for correct recipient of refund.
Performs reconciliation of refund accounts; attaches documentation and forwards to supervisor to process refund checks.
Identifies problems on accounts and follows through to conclusion.
Responds to insurance companies requests for information in a prompt and professional manner.
Reviews appropriate files to identify deceased patients and estates; verifies dollar amounts and files estate to appropriate court in a timely manner.
Reviews EOBs to ensure proper reimbursement of claims and reports any problems, issues, or payor trends to supervisor.
Resubmits insurance claims within 72 hours of receipt.
Participates in maintaining Payor Manuals/Profiles.
Works closely with collection agency to assure that they receive updated information on accounts as necessary.
Prepares write-off requests with appropriate documentation and submits to supervisor.
Processes insurance/patient correspondence, including denial follow-up within 48 hours of receipt. Files all reimbursement correspondence daily.
Works with provided aging to monitor patient account aging and follows up appropriately.
Maintains confidentiality in regard to patient account status and the financial affairs of clinic/corporation.
Other relevant duties as assigned
Must possess a comprehensive knowledge of revenue cycle functions and systems, physician practice revenue cycle operations, revenue metrics and analytics.
Must have strong management and leadership skills that emphasize team building and collaboration. Not afraid to jump in and help with backlogs or projects.
Excellent communications skills, written and verbal with ability to provide clear direction to staff as well as presentation skills.
Proficient with computers and their applications including EMR's, Practice Management systems, databases, and Microsoft Office products such as Outlook, Excel, and Word.
Have a track record of leadership success in healthcare revenue cycle management.
Demonstrated knowledge of the federal, state, and local regulatory requirements around medical billing and coding as well as CMS and payer regulations.
Ability to work independently.
Able to manage multiple projects at once, ability to work efficiently and effectively under tight deadlines.
Demonstrates advanced analytical, evaluative, problem solving and decision-making, fostering innovative approaches to situations/processes/issues.
Strong collaborative leadership qualities, willing to work side by side with staff when “hands on” approach is needed.
Experience in a complex healthcare organization preferred with oncology experience highly desirable.
Requirements
Company Benefits
EOE