Robert Half Medical Accounts Receivable Specialist in Sandy Springs, Georgia
The Accounts Receivable Coordinator II is responsible for the timely follow-up and collection of payments including but not limited to third party payer receivables. This position is the main point of contact between the facility and third-party payers to ensure maximum reimbursement is achieved and aging of receivables is minimized.
The Accounts Receivable Coordinator II files third-party insurance, Medicare and Commercial claims daily as directed by the Director of Revenue Cycle. This position also pursues outstanding accounts and performs verification and prior authorizations.
Functions:Coordinate all insurance verifications and prior authorizations for pharmacy clients File third-party insurance, drug card, and Medicare claims daily for assigned accounts and serve as backup for other accounts as needed. Mail monthly billing statements to clients with third-party insurance and Medicare
for assigned accounts and provide backup for other accounts as needed.Research and solve payment discrepancies. Process correspondence and follow-up related to assigned accounts and provide backup duties for other accounts as needed. Research denied and improperly processed claims by contacting payers to ensure proper processing of said claims. Maintain denial reports and coordinate appeals ensuring that all notes are properly documented. Maintain payers: Humana, Ambetter, as well as Contract Pharmacies: ACH, Baycare and UFL by coding payments and follow up. Coordinating with Payer Relations to ensure smooth transitions with Insurance.
QUALIFICATIONSMedical billing and coding certification At least 3 years’ experience in billing and collecting healthcare claims Familiarity with on-line billing software and ability to learn new software programs. Ability to maintain confidentiality Ability to work independently on assigned tasks as well as to accept direction on given assignments and work collaboratively with team members. Must be accurate and thorough—monitoring own work to check for errors. Proficient in Microsoft Office Suite applications Must be able to lift and carry 30 pounds
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