Family Allergy & Asthma

Accounts Receivable

• The Medical Accounts Receivable Specialist is responsible for demonstrating knowledge and application of job duties within scope of practice
• Functions under the direction of the manager(s) and/or Director(s)
• Respectfully interacts with all levels of staff
• Provides assistance, as needed, during assigned duty hours
• Participates in department activities
• Promotes independence; adherence to the attendance policy; encourages socialization; advocates for the quality of life of our patients while maintaining compliance with all applicable laws, regulatory and organizational standards; supports the company’s core values.
• Understands and has experience with multiple carrier types (Medicare, Medicaid, Dual, Commercial, Managed Care and Advantage plans) in multiple states
• Research and investigate denied or no response claims to confirm reason for denial and best method of recovery
• Reviews payer policies and guidelines to support reconsiderations and appeals where needed
• Identifies trends and notifies leads and manager immediately to establish plan of action
• Submits corrected claims, reconsiderations and appeals via portal, fax or secure email using mail as last resort
• Thoroughly documents research done and action take on each claim in IMS
• Follows SOPs
• Proficient in Excel
• Proficient in Availity Essentials
• Communicates with other departments via shared spreadsheets and conducts regular followups on cross communication

Medical Accounts Receivable Specialist

Call Center Representative

• Answer telephone, handle all calls appropriately, and schedule appointments for new and existing patients
• Enter patient demographics, insurance, and referral information into EMR
• Cancel and reschedule appointments, as assigned
• Work as directed/as needed
• Maintain and follow HIPAA policies and procedures
• Other relevant duties as assigned by the Manager/Director

Call Center Coordinator

Manager

• In conjunction with executive management and other department heads, continuously refine the revenue cycle to minimize denials and appeals while optimizing performance and net cash collections and reduce days in accounts receivable (A/R)
• Continuously monitor established financial and operational benchmarks to identify and resolve variances and exceptions which may affect cash flow
• Strategic planning, monitoring, and execution of metrics to ensure that revenue, profitability, cash flow, business goals and objectives throughout Revenue Cycle operations are achieved
• Oversee development and implementation of policies and standards for all tasks within areas of responsibility
• Work closely with leaders in the areas of Operations, Finance, Credentialing, Human Resources, Information Systems, Analytics, Contracting, and Compliance to achieve business objectives and implement organizational strategy
• Mentor and develop management personnel, including but not limited to clear communication of goals and expectations; timely review of productivity and tracking to goals; honest and timely feedback on performance; and access to training programs required for success
• Deploy technology that enhances outcomes and ensure support for revenue cycle management.
• Assures compliance with all regulatory and accreditation standards and requirements
• Performs other duties as needed and/or assigned

Medical Accounts Receivable Specialist

Call Center Coordinator

Senior Revenue Cycle Manager