Account Receivable Specialist I #Full Time

$44,990 - $54,995/Yr

61St Street Service Corp - Fort Lee, NJ

Full-time - Entry Level

Fort Lee, NJ

Administrative and Support Services

About the position

The Accounts Receivable Specialist I plays a crucial role in the Revenue Cycle by managing follow-up work to collect on all open and unpaid accounts with insurance companies and third parties. This position is essential for ensuring that the organization receives timely payments for services rendered. The specialist will be responsible for inquiring about unpaid claims, appealing denied claims with insurance companies, and maintaining communication with patients or account guarantors. Professionalism and courtesy are paramount in all communications, as the specialist will often be the point of contact for patients and insurance representatives. In this role, the specialist will research the root issues of claim denials and pursue the appropriate course of appeal or follow-up to obtain payment. This includes reviewing account histories for continuous follow-up, addressing incoming correspondence, and preparing necessary communications to insurance companies, patients, or guarantors. The specialist will also be tasked with contacting insurance companies and patients to obtain the status of outstanding claims and submitted appeals, documenting claim issues for review, and escalating issues to the Supervisor as needed. Additionally, the role involves performing charge corrections, updating demographic and insurance coverage information on accounts, and billing new insurance as appropriate. The Accounts Receivable Specialist I may also be required to perform other job duties as necessary to support the revenue cycle process.

Responsibilities

• Research root issue of denial.
• Pursue proper course of appeal or follow up to obtain payment.
• Review account history for continuous follow up.
• Address incoming correspondence.
• Prepare correspondence to insurance companies, patient and/or guarantor, as necessary.
• Contact insurance companies/patient/guarantor to obtain status of outstanding claims and submitted appeals.
• Document claim issue for review.
• Escalate issues and problems to Supervisor as appropriate.
• Perform charge corrections.
• Perform demographic and insurance coverage updates on account and bill new insurance as appropriate.
• Perform other job duties as required.

Requirements

• High school graduate or GED certificate is required.
• A minimum of 6 months' experience in a physician billing or third party payor environment.
• Demonstrate a strong customer service and patient-focused orientation.
• Ability to understand and communicate insurance benefits explanations, exclusions, denials, and the payer adjudication process.

Nice-to-haves

• Experience in Epic and/or other electronic billing systems is preferred.
• Knowledge of medical terminology, diagnosis, and procedure coding is preferred.
• Previous experience in an academic healthcare setting is preferred.

Benefits

• Health insurance
• Paid time off