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Accounts Receivable Specialist
Summary
For more than 20 years, BioTAB Healthcare, LLC has supported patients with lymphatic, wound, and circulatory disorders through proven treatment solutions. Headquartered in Missouri, we provide pneumatic compression devices and personalized service to help improve patient outcomes and quality of life. As a family-owned company, we take pride in delivering expert care with a personal touch service.
The Accounts Receivable Specialist performs resolution oriented activities with a focus on comprehensive medical billing, payment posting, and/or collection actions. While ensuring compliance with relevant laws, regulations and established company policies and compliance programs, this role is responsible for efficient cash collections through excellent reimbursement practices, accurate posting of EFT, credit card, ACH and check insurance/patient payments, and/or performing accurate claim billing. This role, reporting to our AR Supervisors and/or AR Quality & Support Supervisor, will have an emphasis on process execution and quality control.
Key Responsibilities
Payment Posting: EFT, credit card, ACH, live check and insurance payments. Researches and evaluates insurance payments and correspondence for accuracy & process/post insurance and patient payments. Matches EOB and payment records with payments, processing write offs, batching and scanning of payments with applicable record keeping.
Billing: Accurate and timely submission of all claims for all payers, review and prepare daily claim/invoice submission for primary, secondary, & tertiary payers and/or patient statements. Review rejected claims, perform correction activities and ensure resubmission as appropriate. Ensure all Contract Billing Partner billing is submitted to appropriate outsourced partner.
Collections: Timely and accurate follow up on unpaid claims or patient accounts, work assigned lists of outstanding claim balances and/or patient accounts with multifaceted issues across different payers and patients. Identify trends, conduct follow up and perform root cause analysis on unpaid and underpaid insurance claims across different payers. Analyze and resolve billing discrepancies on patient accounts, communicate findings to patient. Draft appeals and effectively overturn denied or underpaid claims, remediation, appeals research, re-bill & payer resolution.
Compliance: Ensuring compliance with relevant healthcare regulations, financial standards, and internal policies.
Prepares year end schedules for Review and other regulatory agencies, assist in monitoring compliance with Medicare regulations. Adhere to all relevant regulations and agency policies regarding patient intake and data management, including but not limited to: CMS and OFCCP guidelines related to our Quality Management System, documentation and process creation and training.
Essential Skills
Analytical Skills: Ability to analyze data, identify trends, and make recommendations.
Communication Skills: Excellent communication and interpersonal skills to effectively collaborate.
Technical Skills: Proficiency in accounting software, Microsoft products with proficiency in Excel. Excellent organizational and time management skills: To manage a high volume of work and ensure timely processing of information.
Attention to detail: To ensure accuracy in patient records and insurance information.
Problem-solving skills: To address any issues or challenges that may arise during the intake process and within the established AR department workflow.
Experience
College degree preferred or related previous experience
1 year minimum: claim submission, payment posting, appeal and denial processes. medical device billing and/or general healthcare reimbursement, medicare and commercial insurance carriers plan configurations in respect to calculations of coinsurance, deductibles and percentages.
Preferred In-Depth Knowledge: Healthcare methodologies in coding, coverage, criteria, payments.
Job Requirements & Physical Demands
● Must be able to lift 40 pounds, must be able to lift 40 pounds from the floor and lift to waist level.
● Must be able to kneel, stoop, climb stairs and reach with hands and arms.
● Reliable work transportation.
● Candidates must pass an extensive background check.
● Strict adherence to HIPAA, Medicare Fraud, Waste, and Abuse and privacy regulations in all patient interactions.
This job description outlines essential duties but is not exhaustive. Employees may be assigned other tasks. All duties are subject to modification for disability accommodation. Successful performance requires specific skills and abilities. This document sets minimum requirements and does not imply an employment contract. The company is an equal opportunity employer, drug-free workplace, and complies with ADA regulations as applicable.
BioTAB Healthcare is an Equal Opportunity Employer. We are committed to fostering, cultivating, and preserving a culture of diversity, equity, inclusion, and belonging. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other legally protected status.
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