Overview
A/R Specialist Jobs in Fresno, CA at Central California Faculty Medical Group Inc
Full Job Description
Description:
JOB TITLE:A/R SpecialistLOCATION:Corporate OfficeFLSA STATUS: Non-Exempt
REPORTS TO:Billing ManagementJOB STATUS:Regular Full-Time
JOB PURPOSE:Position is responsible for researching and resolving outstanding claims issues to ensure maximization of claims reimbursement.
JOB FUNCTIONS:
Monitor all payer types on unresolved claims by running appropriate reports and contacting insurance companies to resolve claims that are not paid in a timely manner. Outbound calls required.
Follow up on all outstanding insurance accounts
Research denials and requests/inquiries from insurance payers
Retrieve supporting documentation from the hospital system for accurate and timely processing of claims
Possess full understanding of EOB’s to ensure payment accuracy and compliance with contract discount
Identifies, analyzes, and escalates trends impacting AR reimbursement.
Review and recommend claims for adjustment/write off to management
Initiate appeals for denied claims as appropriate
Document clear, concise and complete follow up notes in system for each account worked
Contact third party payers and patients to expedite and maximize payment
Work error reports in a timely manner (set by Director/Manager)
Meet with assigned Providers as needed
Collaborate with management to reduce aging of accounts by providing verbal and written communication
Demonstrate expertise of all payers, including Medicare, Medicaid and commercial payers
Meet with insurance carriers as issues are identified
Perform other related duties as assigned
Requirements:
Education:
High school education or equivalent, with specialized training.
Experience:
Preferably two or more years working specifically in professional medical billing and accounts receivable/collections
Two years’ experience using Medical Billing software and Applications
Experience handling confidential data i.e., patient demographic information, payor fee schedules, reimbursement rates, etc.
PERFORMANCE REQUIREMENTS:
Knowledge:
Knowledge of current CPT-4 and ICD-10 coding.
Knowledge of medical terminology and health insurance billing.
Knowledge of common insurance plans i.e., HMO, PPO, Capitation, Medicare and Medi-cal
Skills:
Decision Making
Analytical and problem-solving skills with attention to detail
Strong verbal and written communication
Excellent customer service skills
Proficient computer skills and knowledge of Microsoft Office
Abilities:
Ability to understand and interpret policies and procedures
Ability to communicate effectively and work with others
Ability to apply principles of analytical thinking to extract correct data from documentation
Ability to prioritize and manage multiple tasks
Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction
Ability to work in a fast-paced environment
Equipment Operated:
Standard office equipment including computers, fax machines, copiers, printers, telephones, etc.
Work Environment:
Position is in a well-lighted office environment.
Physical Requirements:
Involves sitting approximately 90 percent of the day, walking or standing the remainder.
Safety:
All employees are responsible for complying with safe and healthful work practices as outlined in CCFMG’s Employee Safety and Injury and Illness Prevention Program and policies and p…
Title: A/R Specialist
Company: Central California Faculty Medical Group Inc
Location: Fresno, CA
Category:
