ADMIN - A/R ASSOCIATE

Description

Position Summary: The Accounts Receivable Associate is responsible for managing and processing billing, and collections for Medicaid, private insurance, other third-party payers, and self-pay accounts. The A/R Associate is also responsible for maintaining client demographic data, verification of benefits, and accurately and efficiently reconciling receivables. This role requires learning aspects of medical billing, claims and remittance processing, and the associated software applications.

Essential Responsibilities: 

· Generate and submit claims and invoices to insurers, third-party payers, and clients, ensuring accuracy and completeness of submissions.

· Verify and maintain data related to client demographics, insurance coverage, benefits, and authorizations. Maintain up-to-date information on payers’ billing requirements and covered services.

· Research and resolve claim denials and other issues impeding reimbursement for billed services. Resolve post-payment inquiries, audits, refunds, and recoupment requests as needed.

· Maintain effective communications within the Agency, clients, third-party payers, and other external organizations to ensure that billing is accurate, timely, and well-documented.

· Report resolved and unresolved charges, status and expected turnaround times for outstanding issues, and projected incomes and adjustments.

· Collect and retain documentation related to A/R activities as appropriate.

· Prioritize responsibilities and work with minimal to moderate supervision, in electronic and paper formats.

· Maintain patient confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).

· Comply with all agency policies.

· Assist the A/R Coordinator and Business Office management with special projects 

· Perform other duties as required

Requirements

Qualifications: 

Education and Experience

· A high school diploma and some experience with accounts receivable and/or benefits verification in a medical or developmental services setting preferred.

· 1 years of experience in Accounts Receivable.

Skills and Abilities

· Proficiency with or ability to quickly software applications including, but not limited to, Microsoft Office Suite, electronic health record and billing systems, and database systems. 

· Understanding of or ability to learn the basics of the revenue cycle, from generation and recording of revenues to collections and cash projections.

· Understanding of or ability to learn medical billing and claims including but not limited to CPT, HCPCS, ICD-10, CMS-1500, and EDI transmissions.

· High attention to detail and an analytical mindset.

· Ability to perform assigned routine functions with a high degree of accuracy and with minimal supervision.

· Familiarity with government benefits programs (Medicaid/Medicare, Social Security, etc.) preferred.

· Ability to work independently, and as part of a team.

· This position requires working on site in the finance office.