We are seeking an Accounts Receivable Specialist to join our client's team! As an AR Specialist, you will play a crucial role in managing financial transactions related to receivables. Your responsibilities will include processing invoices, reconciling accounts, and ensuring timely collections. We are seeking a detail-oriented professional who can contribute to the financial health of our organization. Responsibilities:
- Reviewing and Approving OTP Billing: Ensure accurate and timely processing of billing transactions related to outpatient treatment programs (OTP).
- Investigating Denials and EOB (Explanation of Benefits): Analyze claim denials and EOBs to identify discrepancies and resolve issues promptly.
- Understanding Medicare and ACO/MCOs: Stay informed about Medicare regulations and managed care organizations (ACO/MCOs) to optimize billing processes.
- Payment Rate Reconciliation: Verify payment rates against contractual agreements and reconcile any discrepancies.
- Conducting Audits and Claims Reviews: Perform audits on assigned claims, ensuring compliance and accuracy.
- Processing High-Volume Billing Denials: Handle both manual and electronic processing of billing denials efficiently.
Requirements
- Experience: 2-3 years of experience in accounts receivable or billing in the behavior health field required.
- Education: High School Diploma or GED (required).
- Medical Billing Knowledge: Proficiency in CPT, ICD-10, and HCPC coding, along with familiarity with medical terminology. Overall understanding of managed care products (HMO, PPO, ACO, MCO, etc.).
- Independence and Remote Work: Ability to work independently and remotely while maintaining daily and monthly routines. Commitment to preserving the integrity of electronic health records (EHR).
- EOB Understanding: Skilled at reading and comprehending explanations of benefits (EOBs).
- Medicare and Medicaid Expertise: Strong working knowledge of Medicare and Medicaid benefits.
- Analytical and Problem-Solving Skills: Ability to analyze complex billing scenarios and solve related issues.
- Attention to Detail: Meticulous attention to detail in billing processes.
- Team Player: Collaborative attitude and ability to work effectively within a team.
- Positive Attitude and Time Management: Demonstrates a positive outlook and effective time management skills.
- Microsoft Office Competency: Basic proficiency in Microsoft Word and Excel.
- Accurate Record Keeping: Maintains precise billing records, generates reports, and identifies discrepancies.
- Accounts Receivable Management: Competent in monitoring AR and ensuring correct payment rates from payers.