AR Collections Specialist
Sevita, Minneapolis, MN, United States
OUR MISSION AND PERFORMANCE EXPECTATIONS
The MENTOR Network is a mission-based organization dedicated to providing high quality services to those we serve. Therefore, to deliver on our mission, The Network expects every employee to perform his or her job first and foremost in accordance with the Company’s mission.
Summary The AR Collections Specialist is responsible for following up in a timely fashion on claims that have been paid incorrectly or have not paid at all. They are responsible for communicating with the field and their supervisor any issues preventing a claim from being sent to the payer. They are also responsible for sending claims to the payer in a timely and accurate manner.
Essential Job Functions
Updates collection procedures as necessary
Reviews and works denials in workflow system daily
Reviews and works denials in payer portal and/or clearinghouse portal daily
Reviews and works in DWF for tasks with follow-up dates that are set to expire on that day
Reviews and works in DWF for tasks without a payer response once past 30 days from billing
Follows-up with Field on updates to items assigned to them that are past follow-up date
Updates DWF with clear concise notes as claims are worked
Notifies Field of denials that require their attention
Notifies biller when claims can be electronically rebilled
Sends out paper or complete web portal billing once any necessary corrections have been made
Communicates with Field Finance and SSC Management on issues with collections
Reviews unapplied cash log for any items that can be applied and work with cash team to resolve
Works credit balances on the aging and overpayment account and follow the credit balance procedure for resolution
Prepares appeal packet as required by payer, scan and save documentation to be sent, update DWF with notes and follow-up date and have Supervisor review prior to sending
Follows-up on appeal status with payer after 30 days and then on a bi-weekly basis until paid
Completes necessary forms and provides appropriate support for:
Refunds
Cash move
Sales adjustments
Transfer of Liability
Ensures internal control compliance with all assigned areas and other audit requirements
Assists in the onboarding of new hires by providing required training when necessary
Embraces concept mentoring by actively participating in team meetings and fostering an environment in which team members proactively collaborate with one another
Proactively supports management as well as the objectives and goals of the department
Supports special projects, mission critical initiatives and performs other duties as assigned by the Supervisor
Ensures Sarbanes Oxley compliance with all assigned areas and other audit requirements.
Responsible for the maintenance of an effective control environment under SOX 404 for the accounting operations he or she oversees. This includes both key and non-key controls and extends to the timely updating and modification of control design where necessary and the oversight of control remediation activities should exceptions be encountered in testing.
System testing
Performs other related duties and activities as required
Supervisory Responsibilities None Required
Minimum Knowledge And Skills Required By The Job Education And Experience
High school diploma or equivalent
Associates or Bachelor's degree in a Finance related field preferred
Two to three years of experience with Medical Collections in a high volume environment preferred
Knowledge of ICD-10 diagnosis codes and CPT medical service codes
Knowledge of UB-04 and HCFA-1500 forms
Strong understanding of medical collections compliance
Strong understanding of Medicare, Medicaid, Medicaid managed care, Commercial, Workers Comp and Auto-no-fault payer types
Certificates, Licenses, And Registrations None required.
Other Skills And Abilities
Must be self-motivated and detail oriented
Must have excellent communication skills
Must be highly organized with ability to multi-task
Must have analytical skills and the ability to collect information from different sources
Effectively use Microsoft Office (Word, Excel, PowerPoint, Outlook, etc.)
Other Requirements
Travel as needed
Physical Requirements
Sedentary work. Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
Americans With Disabilities Act Statement External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job functions either unaided or with assistance of a reasonable accommodation to be determined on a case by case basis via the interactive process.
Equal Opportunity Employer Statement As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, citizenship, or any other characteristic protected by law.
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Summary The AR Collections Specialist is responsible for following up in a timely fashion on claims that have been paid incorrectly or have not paid at all. They are responsible for communicating with the field and their supervisor any issues preventing a claim from being sent to the payer. They are also responsible for sending claims to the payer in a timely and accurate manner.
Essential Job Functions
Updates collection procedures as necessary
Reviews and works denials in workflow system daily
Reviews and works denials in payer portal and/or clearinghouse portal daily
Reviews and works in DWF for tasks with follow-up dates that are set to expire on that day
Reviews and works in DWF for tasks without a payer response once past 30 days from billing
Follows-up with Field on updates to items assigned to them that are past follow-up date
Updates DWF with clear concise notes as claims are worked
Notifies Field of denials that require their attention
Notifies biller when claims can be electronically rebilled
Sends out paper or complete web portal billing once any necessary corrections have been made
Communicates with Field Finance and SSC Management on issues with collections
Reviews unapplied cash log for any items that can be applied and work with cash team to resolve
Works credit balances on the aging and overpayment account and follow the credit balance procedure for resolution
Prepares appeal packet as required by payer, scan and save documentation to be sent, update DWF with notes and follow-up date and have Supervisor review prior to sending
Follows-up on appeal status with payer after 30 days and then on a bi-weekly basis until paid
Completes necessary forms and provides appropriate support for:
Refunds
Cash move
Sales adjustments
Transfer of Liability
Ensures internal control compliance with all assigned areas and other audit requirements
Assists in the onboarding of new hires by providing required training when necessary
Embraces concept mentoring by actively participating in team meetings and fostering an environment in which team members proactively collaborate with one another
Proactively supports management as well as the objectives and goals of the department
Supports special projects, mission critical initiatives and performs other duties as assigned by the Supervisor
Ensures Sarbanes Oxley compliance with all assigned areas and other audit requirements.
Responsible for the maintenance of an effective control environment under SOX 404 for the accounting operations he or she oversees. This includes both key and non-key controls and extends to the timely updating and modification of control design where necessary and the oversight of control remediation activities should exceptions be encountered in testing.
System testing
Performs other related duties and activities as required
Supervisory Responsibilities None Required
Minimum Knowledge And Skills Required By The Job Education And Experience
High school diploma or equivalent
Associates or Bachelor's degree in a Finance related field preferred
Two to three years of experience with Medical Collections in a high volume environment preferred
Knowledge of ICD-10 diagnosis codes and CPT medical service codes
Knowledge of UB-04 and HCFA-1500 forms
Strong understanding of medical collections compliance
Strong understanding of Medicare, Medicaid, Medicaid managed care, Commercial, Workers Comp and Auto-no-fault payer types
Certificates, Licenses, And Registrations None required.
Other Skills And Abilities
Must be self-motivated and detail oriented
Must have excellent communication skills
Must be highly organized with ability to multi-task
Must have analytical skills and the ability to collect information from different sources
Effectively use Microsoft Office (Word, Excel, PowerPoint, Outlook, etc.)
Other Requirements
Travel as needed
Physical Requirements
Sedentary work. Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
Americans With Disabilities Act Statement External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job functions either unaided or with assistance of a reasonable accommodation to be determined on a case by case basis via the interactive process.
Equal Opportunity Employer Statement As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, citizenship, or any other characteristic protected by law.
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