Accounts Receivable Specialist

You’re more valuable than ever – And that’s just how we’ll make you feel.

Job Title:

Accounts Receivable Specialist Department:
Revenue Cycle

Reports To:

Manager, Market Revenue Cycle Receives Direction From:
Manager and Senior Manager, Market Revenue Cycle Direct Reports:
None Entity:
Access Clinical Partners, LLC dba GoHealth Urgent CareFLSA Status:
Non-exempt

Work Location:

Remote Job Code: 910009

Job Summary The Accounts Receivable Specialist is responsible for follow up on unpaid claims utilizing monthly aging reports, filing appeals when appropriate to obtain maximum reimbursement and establish and maintain strong relationships with providers, clients, patients and fellow staff.

Qualifications

Education Required:

High school diploma or GEDWork Experience

Required:

3+ years healthcare billing accounts receivable experience in a mid-to-large organization

Preferred Qualifications , Education, Licenses, Certifications, Experience, etc.:3+ years of Healthcare AR experience with large complex physician practice groupsEMR experience across a minimum of one platform (i.e., Epic or Clinical Works)
CPAR – Certified Patient Account Representative Certified Medical Billing Specialist Associate’s degree in Healthcare Management, Health information Management or related field

Knowledge, Skills, and Abilities Technical Knowledge Working knowledge of CPT and ICD coding

Knowledge of basic medical terminology

Understanding of insurance guidelines, including Medicare, state Medicaid, and workers’ compensation across multiple states

Ability to interpret and understand Explanation of Benefits (EOBs)
Ability to accurately calculate deductibles and coinsurance

Communication & Interpersonal Skills This role involves interaction and collaboration with other departments and requires excellent judgment and interpersonal skills.

Ability to maintain strict patient confidentiality

Excellent verbal and written communication skills

Strong phone etiquette and customer service skills

Ability to communicate effectively with patients regarding medical conditions and financial responsibilities

Ability to represent the department professionally when interacting with patients, guests, physicians, and staff

Ability to handle service issues tactfully and professionally and ensure appropriate follow-through

Organizational & Administrative Skills Proficiency in Microsoft Office applications, including Excel and Word Strong organizational and time management skills with the ability to prioritize effectively

Proficiency in computer systems and typing

Strong attention to detail, including mathematical accuracy

Teamwork & Collaboration Ability to work collaboratively across departments and function as an extension of urgent care centers

Demonstrates flexibility and openness to new ideas and approaches

Ability to remain focused and productive under pressure

Proactively shares relevant information with team members

Willingly assists others as needed

Contributes to identifying and resolving enterprise-wide challenges

Essential Duties and Responsibilities Maintain accurate account and billing data by entering and updating patient demographic, guarantor, and insurance information; posting procedures and payments; and reconciling daily deposits.

Manage accounts receivable through full lifecycle resolution, including:

Submitting claims via clearinghouses or directly to payers

Monitoring, researching, and resolving claim denials

Contacting insurance carriers to address payment issues

Filing appeals with appropriate documentation

Processing claim retractions, write-offs, and contractual adjustments in accordance with payer guidelines

Ensure claim accuracy and compliance by entering complete and correct billing information, including patient details, insurance data, diagnosis and procedure codes, modifiers, and provider information.

Review and post payments by:

Verifying insurance payments for accuracy and contract compliance

Posting insurance and patient payments within billing systems

Coordinating secondary billing for patients with multiple insurers

Provide customer support and issue resolution by responding to inquiries from patients, providers, and insurance companies and…