Accounts Receivable Specialist II

Unclassified - Houston, TX

Full-time - Mid Level

Houston, TX

About the position

Retina Consultants of Texas (RCTX) is seeking an Accounts Receivable Specialist II who will regularly interface with NextGen RCM, operational managers, and patients regarding various accounts receivable issues, including, but not limited to invoicing, outstanding accounts receivables, collections, etc. This role requires appropriate use of interpersonal styles and communication methods to develop effective partnerships to meet mutual goals and objectives, demonstrating a strong ability to analyze data, evaluate situations, and identify problems or opportunities, including likely causes. The position is crucial in ensuring that the revenue cycle is managed effectively and that all accounts are handled with the utmost professionalism and accuracy. The Accounts Receivable Specialist II will perform thorough and consistent research of and follow up on accounts with outstanding claims using Worklog Task Manager. This includes researching and resolving insurance claim disputes, providing corrected billing to patients, and assisting in the preparation of appeals according to carrier guidelines for all claims that require reconsideration for appropriate or additional payment. The specialist will ensure that all Third-Party Payor claim filing deadline appeals are submitted timely and that efforts to resolve claim denials for timely filing are exhausted prior to submitting as a write-off or patient responsibility. In addition, the role involves reviewing, monitoring, and identifying trends within the accounts receivable as assigned. The specialist will contact patients and/or the NextGen Revenue Cycle Manager to collect on outstanding receivables as appropriate, answer patient questions regarding their financial responsibilities, and resolve inquiries about coverage. The position also requires evaluating patients' financial statuses and establishing budget payment plans as needed, preparing and approving statements for services that become the patient's responsibility, and performing various collection/payment actions as necessary. The specialist will accept, review coding, scrub, and bill all out/in patient facility claims via NextGen, assist with resolving all non-payment correspondence, underpayments, or overpayments, and document all activity taken in each patient's account via NextGen PM. The role may also involve maintaining knowledge and use of multiple third-party systems that Advocate to manage the revenue cycle process for its providers.

Responsibilities

• Performs thorough and consistent research of and follows up on accounts with outstanding claims using Worklog Task Manager.
• Researches and resolves insurance claim disputes.
• Provides corrected billing to patients.
• Assists in the preparation of appeals via appropriate means according to carrier guidelines for all claims that require reconsideration for appropriate or additional payment.
• Ensures that all Third-Party Payor claim filing deadline appeals are submitted timely and efforts to resolve claim denials for timely filing are exhausted prior to submitting as a write off or patient responsibility.
• Reviews, monitors and identifies trends within the accounts receivable as assigned.
• Contacts the patient and/or NextGen Revenue Cycle Manager to collect on outstanding receivables as appropriate.
• Answers patient questions on patient responsible portions, copays, deductibles, write-off's, etc.
• Resolves patient inquiries or explains why certain services are not covered.
• Identifies and re-assigns financial responsibility as appropriate.
• Evaluates patient's financial status and establishes budget payment plans as needed.
• Prepares and approves statements for services that become the patient's responsibility.
• Performs various collection/payment actions as necessary.
• Accepts, reviews coding, scrubs, and bills all out/in patient facility claims via NextGen.
• Assists with resolving all non-payment correspondence, underpayments, or overpayments.
• Documents all activity taken in each patient's account via NextGen PM.
• Maintains knowledge and use of multiple third-party systems that Advocate to manage the revenue cycle process for its providers.
• Accepts and completes other duties as assigned.

Requirements

• High School diploma, GED, or equivalent.
• At least two years of experience in accounts receivable, billing, and/or revenue cycle management in a medical setting.
• Bilingual Spanish speaker preferred.

Nice-to-haves

• Experience with NextGen RCM.
• Strong communication skills.

Benefits

• Health insurance
• Dental insurance
• Paid time off
• Employee assistance program
• Vision insurance
• 401(k) matching
• Life insurance