Specialist-Accounts Receivable Follow Up
Mississippi Baptist Health Systems, Jackson, MS, United States
Accounts Receivable Follow Up Specialist
The Accounts Receivable Follow Up Specialist performs all collection and follow up activities with third party payers to resolve all outstanding balances and secure accurate and timely adjudication. This position is responsible for net and gross outstanding in accounts receivable, percentage of accounts aged greater than 90 days, cash collections, and denials resolution in support of the team efforts in the achievement of accounts receivable performance goals. The Specialist performs daily activities related to the successful closure of aged accounts receivable.
Responsibilities include:
Performing online account status checks and contacting payers to follow-up on outstanding claim balances of assigned accounts in work queues.
Clearly documenting in EMR system the patient account notes, the payment status of the account, and/or actions taken to secure payment. If applicable, requests account for additional follow up activity within a prescribed number of days in accordance with payer specific filing requirements or processing time required for insurance to complete processing.
Performing required actions to resolve the account balance promptly by submitting appeals, correcting account information, coordinating requests for medical records, requesting and/or performing posting of account adjustments, requesting an account rebill and any and all other actions necessary to secure account payment and/or bring the account to successful closure.
Documenting, tracking, and ensuring a reasonable turnaround time of receipt of any outstanding documents required from external departments.
Responding to claim denials from payers such as inability to identify the patient, coordination of benefits, non-covered services, past timely filing deadlines, and ensuring all information is provided to the payer.
Documenting all actions taken on accounts in the EMR system account notes to ensure all prior actions are noted and understandable.
Informing the supervisor of any problems or changes in payer requirements and exercising independent judgment to analyze and report repetitive denials to take appropriate corrective action.
Achieving established productivity and quality standards as determined by the Baptist Productivity and Quality Expectations Documentation.
Maintaining knowledge of applicable rules, regulations, policies, laws, and guidelines that impact patient account collections. Adhering to internal controls for applicable state/federal laws, and the program requirements of accreditation agencies and federal, state, and private health plans.
Seeking advice and guidance as necessary to ensure proper understanding.
Effectively utilizing payer websites as needed in the execution of daily tasks.
Conducting account claim status and follow up and resolving claim payment denials.
Monitoring assigned work queues at all sources and ensuring expeditious resolution while working with other departmental representatives in resolution.
Reporting unresolved issues and concerns impeding the collection process and to ensure successful account resolution.
Complying with patient confidentiality policies for the retention of patient health information, or when handling, distributing, or disposing of patient health information.
Performing other duties as assigned by the Supervisor.
Specifications include:
Experience:
Minimum Required: Experience in the healthcare setting or educational coursework.
Preferred/Desired: One (1) year experience in physician's office or hospital setting.
Education:
Minimum Required:
Preferred/Desired:
Training:
Minimum Required: PC skills and keyboarding Working knowledge of 10 key, typing and computers. Proficiency in Microsoft Office.
Preferred/Desired: Knowledge of insurance billing and collections and insurance guidelines.
Special Skills:
Minimum Required: Ability to type and key accurately, problem solving, written and oral communication skills, financial counseling skills - knowledge of insurance billing (both hospital and professional settings) and collections - knowledge of insurance guidelines as it relates to CMS guidelines, TennCare and/or Medicaid based by state specified requirements. Ability to recognize and communicate to clinical staff or designee when insurance companies require additional review because of NCCI, CCI, LMRP, Mutually Exclusive and Medical Necessity edits. Effective Verbal, written and customer service skills as it relates to patients and insurance companies. Able to create communications to patients and insurance companies as needed to resolve issues to complete billing/claim processes.
Preferred/Desired: Knowledge of ICD-9, ICD-10, CPT and HCPCS codes and certification and/or degree in Healthcare Administration Business, Finance or related fields preferred.
Licensure:
n/a
The Accounts Receivable Follow Up Specialist performs all collection and follow up activities with third party payers to resolve all outstanding balances and secure accurate and timely adjudication. This position is responsible for net and gross outstanding in accounts receivable, percentage of accounts aged greater than 90 days, cash collections, and denials resolution in support of the team efforts in the achievement of accounts receivable performance goals. The Specialist performs daily activities related to the successful closure of aged accounts receivable.
Responsibilities include:
Performing online account status checks and contacting payers to follow-up on outstanding claim balances of assigned accounts in work queues.
Clearly documenting in EMR system the patient account notes, the payment status of the account, and/or actions taken to secure payment. If applicable, requests account for additional follow up activity within a prescribed number of days in accordance with payer specific filing requirements or processing time required for insurance to complete processing.
Performing required actions to resolve the account balance promptly by submitting appeals, correcting account information, coordinating requests for medical records, requesting and/or performing posting of account adjustments, requesting an account rebill and any and all other actions necessary to secure account payment and/or bring the account to successful closure.
Documenting, tracking, and ensuring a reasonable turnaround time of receipt of any outstanding documents required from external departments.
Responding to claim denials from payers such as inability to identify the patient, coordination of benefits, non-covered services, past timely filing deadlines, and ensuring all information is provided to the payer.
Documenting all actions taken on accounts in the EMR system account notes to ensure all prior actions are noted and understandable.
Informing the supervisor of any problems or changes in payer requirements and exercising independent judgment to analyze and report repetitive denials to take appropriate corrective action.
Achieving established productivity and quality standards as determined by the Baptist Productivity and Quality Expectations Documentation.
Maintaining knowledge of applicable rules, regulations, policies, laws, and guidelines that impact patient account collections. Adhering to internal controls for applicable state/federal laws, and the program requirements of accreditation agencies and federal, state, and private health plans.
Seeking advice and guidance as necessary to ensure proper understanding.
Effectively utilizing payer websites as needed in the execution of daily tasks.
Conducting account claim status and follow up and resolving claim payment denials.
Monitoring assigned work queues at all sources and ensuring expeditious resolution while working with other departmental representatives in resolution.
Reporting unresolved issues and concerns impeding the collection process and to ensure successful account resolution.
Complying with patient confidentiality policies for the retention of patient health information, or when handling, distributing, or disposing of patient health information.
Performing other duties as assigned by the Supervisor.
Specifications include:
Experience:
Minimum Required: Experience in the healthcare setting or educational coursework.
Preferred/Desired: One (1) year experience in physician's office or hospital setting.
Education:
Minimum Required:
Preferred/Desired:
Training:
Minimum Required: PC skills and keyboarding Working knowledge of 10 key, typing and computers. Proficiency in Microsoft Office.
Preferred/Desired: Knowledge of insurance billing and collections and insurance guidelines.
Special Skills:
Minimum Required: Ability to type and key accurately, problem solving, written and oral communication skills, financial counseling skills - knowledge of insurance billing (both hospital and professional settings) and collections - knowledge of insurance guidelines as it relates to CMS guidelines, TennCare and/or Medicaid based by state specified requirements. Ability to recognize and communicate to clinical staff or designee when insurance companies require additional review because of NCCI, CCI, LMRP, Mutually Exclusive and Medical Necessity edits. Effective Verbal, written and customer service skills as it relates to patients and insurance companies. Able to create communications to patients and insurance companies as needed to resolve issues to complete billing/claim processes.
Preferred/Desired: Knowledge of ICD-9, ICD-10, CPT and HCPCS codes and certification and/or degree in Healthcare Administration Business, Finance or related fields preferred.
Licensure:
n/a