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Accounts Receivable Specialist -Medical Billing
Accounts Receivable Specialist -Medical BillingCore Clinical Management LLC • Lafayette, LA, US
Accounts Receivable Specialist -Medical Billing

Accounts Receivable Specialist -Medical Billing

Core Clinical Management LLC • Lafayette, LA, US
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Job Description

Job Description

Description :

Core Clinical Partners stands at the forefront of Emergency and Hospital Medicine, delivering unparalleled services through a model that emphasizes patient-centric care and operational excellence. Our corporate values – Genuine, Accountable, Dynamic, Respectful, and Fun – are the pillars that uphold our commitment to revolutionize healthcare delivery.

The Accounts Receivable Specialist will utilize multiple EMR systems to review and satisfy billing edits, charge information, private or government insurance benefits, and other related information from multiple billing and documentation servers (for multiple hospitals, clinics and insurance companies). Under the direction of the AR Manager, the AR Specialist will follow up on outstanding AR all payers including self-pay and resolution of denials. This position is responsible for handling all correspondence related to an insurance or patient account, contacting insurance carriers, patients and other facilities as needed to get maximum payment on accounts and identify issues or changes to achieve client profitability.

Essential Duties :

  • Investigate, follow up with payers, and collect the insurance accounts receivables assigned by the manager of outsourced and internal AR aging, clearinghouse rejections, and payer denials.
  • Perform comprehensive follow up activities that facilitate cash collections and document follow up activity in the appropriate system.
  • Maintain professional interaction with colleagues and clients
  • Identify any payer-specific issues and communicates to team and manager
  • Comply with performance and productivity standards while maintaining quality levels, as set forth by senior leadership
  • Navigating and utilizing payer websites for appeals / reconsiderations, medical records attachments, verification of benefits and / or web-based claims follow up
  • Researches and completes special projects and requests as needed.
  • Participates in staff meetings and assigned continuing education, and recommends new approaches, policies, and procedures to effect continual improvement in efficiency of the department and services performed.
  • Maintains a strict level of confidentiality for all company, departmental, and healthcare provider information.
  • Performs other related duties as assigned.

Skills, Knowledge, Abilities :

  • Analytical – Collects and researches data.
  • Communications – Expresses ideas and thoughts verbally; expresses ideas and thoughts in written form; exhibits good listening and comprehension; keeps others adequately informed; selects and uses appropriate communication methods.
  • Continuous Learning – Assesses own strengths and weaknesses; seeks feedback to improve performance; participates in training and development opportunities; strives to continuously build knowledge and skills.
  • Customer Service – Displays the ability to manage difficult or emotional customer situations; responds promptly to customer needs; solicits customer feedback to improve service; responds to requests for service and assistance; meets commitments.
  • Dependability – Follows instructions and responds to management direction; takes responsibility for own actions; keeps commitments; commits to long hours of work when necessary to complete tasks or reach goals; completes tasks on time or notifies appropriate person.
  • Ethics – Treats people with respect; keeps commitments; inspires the trust of others; work with integrity and principles; upholds organizational values.
  • Job Knowledge – Has knowledge of commonly-used concepts, practices, and procedures within the field of Accounts Receivable; exhibits ability to learn and apply new skills; keeps abreast of current developments; requires supervision; displays understanding of how job relates to others; uses resources effectively.
  • Judgement – Displays willingness to make decisions; exhibits sound and accurate judgment; supports and explains reasoning for decisions; includes appropriate people in decision-making process.
  • Planning and Organizing – Prioritizes and plans work activities; uses time efficiently; sets goals and objectives; develops realistic action plans.
  • Problem Solving – Identifies and resolves routine problems in a timely manner; gathers and analyzes information skillfully; displays the ability to recommend alternate solutions; works well in group problem solving situations; uses reason even when dealing with emotional topics.
  • Project Management – Communicates changes and progress on assigned project tasks; completes projects on time.
  • Navigate competing priorities and effectively work in a fast-paced environment
  • Ability to work within a team environment and maintain a positive attitude while supervising team members
  • Exhibit growth mindset and team-orientated behaviors
  • Collaborate with professionals internal and external to the company and across geographic locations
  • This is a hybrid role based out of our Lafayette, LA office.

    Core Clinical Partners is an equal opportunity employer, drug-free workplace, and complies with ADA regulations as applicable.

    Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

    Requirements : Education :

  • High school diploma required
  • Bachelor’s degree in Business Administration, Healthcare Administration, or related field preferred.
  • Experience :

  • Minimum of three (3) years of healthcare Revenue Cycle experience.
  • Prior experience in accounts receivable or related financial role preferred.
  • Experience using payer software and EMR systems preferred.
  • #LI-LM1

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    Medical Billing Specialist • Lafayette, LA, US

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