Accounts Receivable Specialist

Division:

Eskenazi Health  Sub-Division:
Hospital  Req :  26106

Schedule:

Full Time

Shift: Days Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 333-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus including at a network of Eskenazi Health Center sites located throughout Indianapolis. FLSA Status Non-Exempt

Job Role Summary
The Accounts Receivable Specialist is responsible for maintaining the life of a claim which includes the following:
Claims Submission and Processing, Charge Entry, Claim Edit, DNB, Stop Bills, Claim Rejection, Denial Management, Accounts Receivable Follow-up, No Response, Compliance and Billing Regulations, Variance, Correspondence and Credit Balance Resolution. The Accounts Receivable Specialist communicates with the insurance carriers to ensure appropriate and compliant payment of services via telephone, email, fax, payor website. This position reviews reports to determine trends and discusses with management to help resolve front-end errors, reviews and follows up on all claims not paid by carriers in a timely manner and claims not paid appropriately.

Essential Functions and Responsibilities Proactively contributes to Eskenazi Health’s mission:
Advocate, Care, Teach and Serve with special emphasis on the vulnerable population of Marion County.
Models Eskenazi Health values of Professionalism, Respect, Innovation, Development and Excellence.

Assist customer service with follows up on patient calls within a timely manner Maintains department weekly production and monthly quality measures

Communicates effectively and appropriately with internal and external customers Acts independently seeking guidance when necessary to remain compliant with federal, state, and hospital policies relative to insurance patient billing.

Initiates proper course of action for problem solving resolution Analyzes all claim denials to determine the best course of action to resolve any issue and receive appropriate payment

Verifies and updates claims with insurance and demographic information when changes are needed

Resolves inquiries from internal and external customers

Takes active role in special projects as requested

Gathers and distributes insurance information obtained through verbal and/or written communication for the purpose of maintaining sufficient cash flow Analyzes and resolves issues reported from the self-pay outsource vendor

Utilizes interpersonal communication strategies/skills to achieve desired outcome/results with patients/families and others Provides coverage for co-workers as necessary due to PTO/illness Continuing knowledge-based learning on payor guidelines and requirements for appropriate billing

Enter daily charges for NTP clinic

Works charge review in a timely and accurate manner to ensure appropriate billing of services

Investigate and Resolves claim edits, rejections (internal/external), DNB, Stop Bills, follow up, variance, monitoring status of denials, denials, appeals, credit balance resolution and correspondence.

Work queue management for better efficiency of work flows i.e. filters and rules. Follows up on unpaid claims with insurance companies.

Initiate Billing/Charge Review resolution

Job Requirements Associate Degree in business-related field or technical training in coding and/or billing in lieu of Three years of experience in medical practice/hospital setting with billing, insurance follow-up and/or credit balance experience.

CPC Certification a plus Dental, Vision, Behavioral Health and/or DME experience a plus Knowledge, Skills & Abilities Pays close attention to detail with accuracy in record keeping and documentation

Identifies trends with denials (providers/locations/carriers) and works with management to help educate or resolve errors from the start and avoid back-end denials

Willingness and ability to assist other team members

Excellent problem-solving skills and ability to cooperate with others

Works independently and efficiently

Working knowledge of Microsoft Office Software, Windows Utilizes calculator, printers, copiers, and fax machines

Strong math skills

Strong organizational skills and ability to work efficiently in a high volume, multi-task environment meeting deadlines

Uses professional and appropriate communication skills

Advanced understanding of health insurance medical policy and billing requirements,…