Accounts Receivable Specialist - Medical Claims
Remote U.S. (designated states)
This position is fully remote and may be performed from one of the following U.S. states: AL, AZ, FL, GA, IN, KS, MA, MI, MS, NC, NV, OR, PA, SC, TN, TX.
The Accounts Receivable Specialist ensures accurate, compliant, timely billing and appropriate reimbursement for multispecialty medical professional services from various insurance payers and patients.
This includes correct and timely collection of unpaid patient accounts with goals to be met, re-billing, payment posting, contractual write-offs, adjustments, appeals per multi-state and federal insurance regulations for patients receiving services with our clients.
Duties and Responsibilities:
- Prepare and re-submit clean claims to various insurance companies either electronically or by paper in accordance with specific payer guidelines and/or contract requirements.
- Analyze and correct first pass rejected claims for completeness and accuracy of information for second pass clean claim submission.
- Research and perform all primary and secondary billing claim status follow up activities for assigned insurance plans.
- Review, evaluate and process all claim appeals through resubmission to insurance carriers with complete and accurate supporting documentation required.
- Research and recommend any customer account adjustments and/or write-offs to the Manager based upon collectability of account with insurance carrier or patient.
- Recognize and report claims problems, errors, and discrepancies to management in order to proactively identify and effectively resolve billing trends in a timely manner.
- Generate and submit monthly patient balance due statements to customers as dictated by the explanation of benefits received from their insurance carrier.
- Reviewing patient accounts, identifying delinquent accounts, and collecting overdue payments.
- Answering patient questions about billing and payments.
- Investigating and/or directing patient inquiries or complaints to the appropriate staff member.
Position Proficiencies and Requirements
- High School Diploma, GED, or equivalent work experience.
- Experience in Medical Insurance Claims billing preferred.
- One to three (3) years of experience with a 10-Key by touch.
- Proficient in Microsoft office (Outlook, Excel, Word) and Google applications.
- Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Ability to define problems, collect data, establish facts, and identify trends.
- Ability to exercise good judgment and escalate issues appropriately.
Competencies to Drive Success
- Strong written and verbal communication skills; a self-starter who is dependable and reliable.
- Must work well within a team structure, possessing outstanding interpersonal relationship skills, as well as the ability to work independently.
- Strong organizational skills and detail oriented with the ability to prioritize, complete tasks, and meet deadlines.
- Must be able to promote a positive influence within the team, department, and company.
- Ensure and adhere to departmental compliance with HIPAA guidelines, Raintree Systems, Inc. HR policies, standard operating procedures, and other corporate initiatives.
Our Perks
- Remote Work/Work From Home
- Paid Time Off/11, Paid Holidays/Year-End Holiday Break
- Health, Dental, Vision, HSA/FSA
- 401K with Company Match
- Disability & Life Insurance
- Employee Assistance Program
- Paid Parental Leave
About Raintree Systems
Raintree is the preeminent platform for enterprise and mid-sized therapy provider organizations. Our award-winning solutions in patient engagement and communications, clinical documentation, revenue cycle management (RCM), and business intelligence are tailored to the needs of physical therapy, occupational therapy, speech therapy, and ABA practices across all treatment settings.
Our Core Values
We put our Clients First - We are Open and Honest - We are Disciplined, Yet Flexible
We love to Solve Problems - We are Committed to Greatness - We are a High Performance Team
Raintree Systems provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
Protect yourself from recruitment fraud: Raintree will never ask for financial information of any kind or for any payment during the job application process. We will never ask for personal information during the interview process such as passport number, bank account number, or social security number and will never ask you to receive and ship packages or goods. Our recruitment process takes place via zoom or in person. Any emails from Raintree recruiters will come from an @raintreeinc.com email address.
Experience Requirements
Mid Level
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