House + Home Loans

Accounts Receivable

• Contact insurance carriers on a daily basis to follow up on/collect past due amounts on outstanding medical claims regarding denials or benefit changes
• Maintain an accurate, up to date aging of assigned accounts including AR analysis and follow up
• Keep educated on billing and medical policies for all payers; work knowledge of In and Out of Network reimbursement processes/methodologies
• Create and follow up on appeals needed to protest denials or incorrect payments
• Review complex denials/tasks assigned by the payment posting team and resolve accordingly including reviewing refund requests, disputes and appeal as necessary
• Work across all RCM departments to get issues related to claims payment resolved
• Work with AR Supervisor to review/resolve open accounts as assigned
• Uphold and ensure compliance with company policies and procedures as well as state and federal regulations; perform other duties as assigned

Accounts Receivable Specialist