Altru Health System

Accounts Receivable Specialist

Location
Grand Forks, ND
Salary
Join our team!
Posted
Jan 31, 2018
Ref
22131
Role
Accountant
Job Type
Long-Term
The Accounts Receivable Specialist assists patients with their written, telephone or in person inquiries for the clinic and hospital billing system; reviews, edits, prepares and submits insurance claims; identifies claims which cannot be transmitted; reviews and monitors insurance EOB's and denials to ensure proper payment; tracks pending eligibilities and unpaid claims; works credit balances and underpayment work queues; analyzes, edits and reviews accounts 5 highest dollars and 5 oldest on each assigned work queue; phones third party payers and checks websites to ascertain reason for non-payment of claims; demonstrates sound working knowledge of government regulations and other insurers' requirements, and monitors insurance bulletins and newsletters; reviews insurance correspondence and fills out questionnaires; acts as a back up to co-workers, and assists the Manager/Supervisor in defining new requirements, suggesting solutions and testing additional systems or enhancements, and identifies delays, inefficiencies and errors which hinder the claim process.

Primary Job Duties:
-Assists patients with their written, telephone or in person inquiries for the clinic and hospital billing system.
-Reviews, edits, prepares and submits insurance claims to the appropriate party.
-Identifies claims which cannot be transmitted and requests paper claims (UB and CMS 1500) from the appropriate system.
-Reviews and monitors insurance EOB's and denials to ensure proper payment.
-Tracks pending eligibilities and unpaid claims from the work queue daily.
- Works credit balances and under payment work queues daily.
-Analyzes, edits and reviews accounts 5 highest dollars and 5 oldest on each assigned work queue on a daily basis.
-Phones third party payers and checks websites to ascertain reason for non-payment of claims 45 days past the filing date.
-Demonstrates sound working knowledge of government regulations and other insurers' requirements, and monitors insurance bulletins and newsletters.
-Reviews insurance correspondence and fills out questionnaires.
-Acts as a back up to co-workers by assisting with all job duties as needed or directed by Insurance Representative or Supervisor.
-Assists the Manager/Supervisor in defining new requirements, suggesting solutions and testing additional systems or enhancements, and identifies delays, inefficiencies and errors which hinder the claim process.

Required:
•Associates Degree from a Business/Technical school or equivalent work experience.
•Effectively demonstrates multi-tasking and capabilities within job and projects, while maintaining a positive, professional and customer service based attitude.
•Computer experience and knowledge of various software applications.
•Ability to work independently.
•Possesses customer service and problem solving skills.
•Demonstrated ability in managing relationships with multiple departments and employees.

Preferred:
•CPT/HCPCS/ICD9 coding knowledge.
•Knowledge of medical terminology.
•Previous experience with filing insurance claims.

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