JOB FUNCTIONS

The primary responsibility of the AR Specialist is to actively work assigned clients accounts receivable, and rapidly respond telephone inquiries from patients.

Works and coordinates with RCM to ensure smooth and efficient operation in all areas of accounts receivable

Works necessary reports to ensure assigned client AR is actively worked & maintained

Serves as client/patient support to assigned clients

ACCOUNTS RECEIVABLE RESPONSIBILITIES

Works Denials Daily

File Rejected

Denial Report

In Progress Non-Primary

Sent Secondary Crossover

Review Bad Address report weekly

Update patients address in Centricity when report provides updated information

Those without new information, send list to practice contact with MRN # advise mail being returned need update, or log-in to EMR, any changes or updates then made to the patients account in Centricity.

Bill Status Report Hold Charges

Reviews charges on hold weekly, and coordinates with charge processor to ensure timely release of charges to avoid untimely filing

CLAIM SUBMISSIONS CORRECTIONS

Will review, prepare, and submit claims to third party payers (primary and secondary) according to established policies and procedures

DEMOGRAPHICS

Will retrieve, review, verify benefits, and update new insurance information as needed

Move demographic files to GeBBs daily for assigned clients

Sign-off on Daily Client Charge Log for demographics;

Sign-off on Month-end Log by 5th business day of the month

CORRESPONDENCE

Receives and processes miscellaneous correspondence from patients, insurance companies and clients within 48 hours

Accounts Receivable follow-up

Pulls EOB's

REFUNDS

Will actively review, prepare submit;

Refund requests

Account adjustments

COLLECTIONS

INSURANCE COLLECTIONS

Run Stop report monthly. The STOP report is used to identify, and facilitate successful collection of both patient and unpaid insurance claims upon completion of patients course of treatment

Identify unpaid claims, and set reminders to actively work to a successful conclusion

Monitor patient balances, and actively move through collections process including setup payment arrangements

AGING REPORTS COLLECTION EFFORTS EXHAUSTED

Aging by Financial Class, Patient

And any other reports identified to assist in this process by RCM

PATIENT COLLECTIONS

Will review, prepare and submit patient supplemental bills to patient(s)

Assist with payment arrangements

Identify Self-pay patients for assigned clients;

verify monthly eligibility with Medicaid

follow-up with practice charity status

Assists in processing credit card payments from patients

Maintain current list of medical policies for the various procedures, and or diagnosis covered by those entities

Ensure all corporate guidelines are maintained and practiced daily

Maintain a Team Player attitude at all times

Communicate professionally with management, Offshore, and peers

Report Denial Trends to RCM

Attend AMAC-USA Webinars

Knowledge of reading and understand an EOB

Other projects as assigned