Medical A/R Specialist

Emergicon - Terrell, TX

Full-time - Entry Level

Terrell, TX

1-10 employees

Professional, Scientific, and Technical Services

About the position

The Medical Accounts Receivable Specialist at EMERGICON LLC is a vital role responsible for ensuring the timely reimbursement of medical claims. This position involves a thorough review of claims, following up with insurance carriers and patients, and identifying trends in accounts receivable management. The specialist will manage claims that are over 60 days old, ensuring that all necessary actions are taken to facilitate payment. This includes working on assigned denials and correspondence, utilizing clearinghouse and insurance portals to check claim statuses, and preparing corrected claims and appeals as needed. The role also requires processing inbound and outbound calls to insurance carriers and adhering to all state and federal collections and HIPAA laws. The specialist will report any trends detected in accounts receivable management to the lead or manager for further review, ensuring that the department operates efficiently and effectively. In addition to these responsibilities, the Medical Accounts Receivable Specialist will be expected to perform other job-related duties as assigned. This role is essential in maintaining the financial health of the organization by ensuring that claims are processed correctly and in a timely manner, thereby supporting the overall operations of EMERGICON LLC. The ideal candidate will possess a strong attention to detail, excellent communication skills, and the ability to work collaboratively with other staff members to achieve departmental goals.

Responsibilities

• Manage all claims over 60-days on the A/R reports in a timely manner
• Work assigned denials and correspondence
• Utilize clearinghouse and insurance portals for claim status
• Report all trends detected in A/R management
• Prepare corrected claims and appeals, as needed
• Process inbound and outbound calls as needed to insurance carriers
• Follow all state and federal collections and HIPAA laws
• Other job-related duties as assigned

Requirements

• High School Diploma or GED
• Medical A/R experience required; EMS billing preferred
• Maintain certifications applicable to job functions
• Computer literate with ability to type a minimum of 40 WPM
• Ability to communicate effectively and in a professional manner
• Detail oriented
• Knowledge of managed care plans, insurance, and medical terminology
• Knowledge of reimbursement fee schedules (Medicare and Medicaid)
• Knowledge of refund processes and requirements
• Ability to establish/maintain cooperative working relationships with staff
• Ability to prioritize and multi-task

Nice-to-haves

• Experience in Medicare A/R, commercial insurances, appeals, correspondence, and denials is a plus.