- Manage denial inventory for all assigned payer plans.
- Managed aged claim inventory for all assigned payer plans.
- Responsible for keeping management informed of payer trends and issues resulting in delay of reimbursements.
- Timely submission and follow-up of appeals and grievances.
- Respond to patient and insurance inquiries in a timely manner and update accounts as necessary.
- Manage payer issue projects and bulk appeals.
- Identify, document, and perform claim adjustments.
- Manage insurance correspondence.
- Verify patient eligibility as necessary.
- Participates in on-going training for compliance, payer information, and insurance benefits to augment knowledge of procedures, regulations, and products.
- Comply with performance standards and departmental goals.
- Assist with overflow calls for PFS as needed.
- Maintains HIPAA compliance.
- Uphold all SMIL policies and procedures.
- Other duties as deemed necessary.
- High School Education or General Education Degree (GED) required.
- Minimum 1 year of experience in medical accounts receivable preferred.
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Accounts Receivable Specialist - Scottsdale, United States - Southwest Medical Imaging
Description
Job Description
Job DescriptionSince 1980, SMIL has evolved into the premier imaging provider in the southwest. SMIL won the 2016 Southwest Alliance for Excellence award for customer and employee satisfaction, sound management, innovation and results. SMIL was again recognized with the prestigious Advisory Board Company's 2017 Workplace of the Year Award, and in 2019 SMIL was named a World Class Employer by Birdeye Surveys, Inc.
Employee engagement is part of everything we do at SMIL. We are dedicated to the growth of our employees including cross training and leadership career opportunities. Simply put, our culture is what sets us apart from the rest.
We offer competitive pay, career opportunities and benefits that include; medical, HSA employer contribution, dental, vision, paid time off, paid holidays, 401K and company paid profit sharing, tuition and continuing education reimbursement, paid life insurance, paid long term disability as well as voluntary short term disability.
We look forward to having you join our amazing team
Position Summary
The Accounts Receivable Specialist ensures the timely receipt of revenue for aged and rejected claims. Specialist must be able to problem solve a variety of reimbursement issues by filing appeals, following up on claims, and working collaboratively with management as well as provider representatives. Work involves monitoring Medicare, Medicaid, commercial insurance, and other third party payers for compliance with various regulatory requirements, policies, and procedures. This position supports Patient Financial Services to resolve billing system questions and issues.
Detailed Responsibilities
Qualifications
Physical Requirements:
While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel; reach with hands and arms and talk and hear. Specific vision abilities required by this job include close vision, color vision, ability to adjust focus. The employee is frequently required to sit and must be able to remain in a stationary position while performing the essential duties of this position. Inside general air-conditioned, nonhazardous environment only with light background noise.
Job Posted by ApplicantPro