Accounts Receivable Specialist

Gi Care For Kids - Atlanta, GA

Full-time

Atlanta, GA

Ambulatory Health Care Services

About the position

The Accounts Receivable Specialist is responsible for managing accounts receivables with insurance companies and self-pays, ensuring timely follow-up and resolution of claims. This role requires strong customer service skills, attention to detail, and the ability to handle multiple tasks efficiently. The specialist will communicate with various departments and patients to facilitate the collection of payments and resolve billing inquiries.

Responsibilities

• Follow up on all accounts within the timely filing guidelines of the insurance company assigned to the biller.
• Correct claim issues and/or rebill claims to third party payers within the timely refiling guidelines.
• Write appeal letters as necessary.
• Communicate with front desk staff, nursing, and providers to ensure appropriate collection of co-pays and self-pay balances prior to patient visits.
• Contact patients to discuss collection of out-of-pocket expenses prior to visits after obtaining authorization.
• Document communications regarding balances that need to be collected.
• Handle inquiries and answer questions for clerical staff, clinical staff, and insurance companies within a 24-hour turnaround time.
• Monitor assigned insurance A/R's and statuses on delinquent self-pay accounts.
• Meet deadlines for completing all assigned work queues prior to the end of the month.
• Identify and resolve patient billing questions from office and incoming calls.
• Collect and/or post payments from insurance companies and patients daily.
• Review accounts and make recommendations regarding non-collectible accounts.
• Notify manager of non-collectible self-pays and insurance balances.
• Verify patient eligibility through various third-party sources.
• Understand patient benefits from various insurance carriers and determine out-of-pocket costs prior to visits.
• Document payments collected and phone call resolutions in the software system.
• Understand fee schedules and update manager on changes and effective dates.
• Monitor changes in policy and fee schedules for all assigned insurance carriers and inform manager.
• Answer business office phone calls daily and on a rotating schedule.
• Explain out-of-pocket expenses to guarantors.
• Assist in enrollment and explain drug rebate programs to patients.
• Communicate effectively with professional staff and patients.
• Monitor personal business office phone line and respond to messages promptly.
• Collect and route business office mail to appropriate billers.
• File manually posted payments and be cross-trained for other job functions as needed.

Requirements

• Associate's degree or equivalent experience.
• 3 to 5 years related experience in accounts receivable or medical billing.
• Medical Billing Certification preferred.
• Experience working with medical payers including Medicaid, CMO's, and Commercial insurance.
• Working knowledge of medical billing systems, particularly Epic.
• Familiarity with CPT and ICD-10 coding systems.
• Strong research and problem-solving skills for A/R disputes.
• Excellent customer service orientation.
• Dependable, self-starter with excellent organizational skills.
• Proficiency in Microsoft Office Suite.
• Strong verbal and written communication skills.
• Knowledge of medical billing and collection practices required.
• Strong keyboard skills and ability to work under firm deadlines.

Nice-to-haves

• Experience in patient monitoring.
• Ability to work both independently and as part of a team.
• Strong analytical skills.