Accounts Receivable Specialist/Denial Follow up Specialist

EyeCare Partners - Ballwin, MO

Full-time - Entry Level

Ballwin, MO

501-1,000 employees

Ambulatory Health Care Services

About the position

EyeCare Partners is seeking an experienced Accounts Receivable Specialist/Denial Follow-up Specialist to join our growing eye care organization. This position is crucial in ensuring that unpaid claims are thoroughly researched and followed up on, particularly in the insurance domain. The ideal candidate will possess a compassionate demeanor and a natural inclination to assist others, demonstrating a commitment to resolving issues effectively and efficiently. In this role, you will be responsible for reviewing unpaid claims and investigating the reasons behind any delays. You will initiate follow-ups for collections on unpaid or denied claims with the appropriate payers, ensuring that all necessary information is gathered to facilitate the resolution of these claims. Your ability to research appeals and resolve claim rejections, underpayments, and denials will be essential in maintaining the financial health of our organization. Additionally, you will communicate any payment or denial trends that may impact revenue to leadership, helping to inform strategic decisions. Building and maintaining positive working relationships with team members and payer representatives will be a key aspect of your role, as will contacting insurance companies to address discrepancies and ensure claims are paid. You will also review outstanding accounts and aging reports, processing any necessary adjustments as needed.

Responsibilities

• Review unpaid claims and research reasons for delay
• Initiate collection follow up of unpaid or denied claims with the appropriate payer
• Research appeal and resolve claim rejections, underpayments and denials with payers
• Process appeals by gathering information and resubmitting claims
• Communicate payment or denial trending that impact revenue to leadership
• Develop and maintain positive working relationships with team members and payer representatives
• Contact insurance companies to work out any discrepancies and get the claims paid
• Review outstanding accounts and aging report
• Process any adjustments as needed

Requirements

• High school diploma or equivalent required
• 1+ years' experience with account follow up, preferably in a healthcare environment
• Excellent verbal, written, and social skills
• Ability to work overtime if/when needed
• Strong knowledge of explanation of benefits (EOB's)