Overview
Accounts Receivable Billing Specialist
Full Time TEMPORARY POSITION (Six Months or longer)
$20.00 per hour
The Billing Specialist – AR Follow Up is primarily responsible for patient revenue management support throughout the revenue cycle, including but not limited to: Cash Posting, Claims Management, Accounts Receivable, and Denials Management. The Billing Specialist must ensure compliance with the philosophy, policies, procedures, and goals of CFG.
Responsibilities
Performance Expectations:
- Identifies and analyzes denials and payment variances and acts to resolve accounts including drafting and submitting appeals, identifying specific reasons for underpayments, denials and causes of payment with the goal of maximizing collections.
- Communicates with payers to resolve issues and facilitate prompt payment of claims.
- Performs due diligence in reconciling outstanding balances ensuring all efforts have been exhausted in resolving issues with payers prior to write-off.
- Responds to inquiries or follow up on issues and provide information to resolve outstanding balances.
- Works with leadership to identify, trend and address root causes of issues in the AR.
- Analyzes EOB information, including co-pays, deductibles, co-insurance, contractual adjustments, and denials to verify the accuracy of patient balance.
- Conducts thorough reviews of aged accounts receivable balances and follows up with insurance companies to ensure that claims are paid timely and appropriately.
- Conducts thorough reviews of patient account balances to ensure all patient payments are applied appropriately.
- Contact patients, insurance companies, and other relevant parties to follow up on outstanding balances and negotiate payment arrangements.
- Responds to patient complaints, questions, and concerns regarding the billing process.
- Maintains detailed records of collection activities, including payment arrangements, follow-up actions, and resolution outcomes.
- Determines write-off's per the CFG Adjustment Policy.
- Handles provider appeals where appropriate.
- Collaborates with the internal team to address billing issues and improve revenue cycle management processes.
- Verifies health insurance benefits for patients
Skills & Knowledge
- Thorough understanding of the revenue cycle process, from patient access (authorization, admissions) through Patient Financial Services (billing, collections) procedures and policies
- Ability to read and interpret explanations of benefits, insurance denials, partials payments, adjustments, and recoupments
- Proficiency in Microsoft Office Suite with excellent knowledge of Microsoft Excel
- Strong written and verbal communication
- Strong analytical, mathematical, and report writing skills
- Above average customer service & interpersonal skills
- Strong problem-solving and critical-thinking skills
- Comprehension of industry-specific policies
- Knowledge of CPT/ICD10, medical terminology, multiple state jurisdictional regulations and rules, Fee Schedules, and Usual and Customary Guidelines
- Leadership skills and ability to motivate others
- High level of accuracy and attention to detail
- Ability to handle deadlines and proactively problem-solve
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies
- Well-organized, self-motivated, and have the ability to multi-task while working in a fast-paced environment
- Knowledge of computers or hospital billing systems
Qualifications
Education & Licensing
- High School diploma or GED required. Medical billing coding education highly recommended
Experience
- Two (2) years of hospital/doctor office billing preferably in psychiatry or equivalent combination of education and experience required to include provider appeals experience.
- Minimum of Two (2) years of experience with complex medical and consult review preferred.
EEO/M/F/D/V
Company Profile CFG is a comprehensive healthcare provider that is dedicated to improving quality of life for individuals and families by providing innovative medical and mental health services. Our Health Network includes Center for Family Guidance, CFG Health Systems and CFG Residentials.Job Category Administrative/Non-clinical