Summary:

The Accounts Receivable Specialist is responsible for insurance and patient balance claims. The Accounts Receivable Specialist will serve as the point of contact for billing inquiries. Accept incoming calls from insurance, patient or guarantor and/or contact insurance, patient or guarantor to discuss the status of claim and/or account. Make all necessary efforts to collect payment according to CenterPlace Health, Inc. and departmental policies and procedures. The individual will provide follow up of accounts until they are resolved. The employee anticipates and prioritizes work, clarifying directions and timelines.  Tracks and completes tasks in a timely manner, without reminder.

Essential Functions:

• Respond to billing inquiries from patients and CPH employees. Makes every effort to troubleshoot and resolve billing issues efficiently and timely. Document and resolve patient billing complaints. Presents recommendations for further considerations to management.
• Set up and monitor patient payment plans according to CenterPlace Health, Inc. and departmental policies and procedures.
• Responsible for working in the AR aging, insurance claim follow-ups, appeals and denials for all payers: Medicare, Medicaid, and Insurance/Commercial payers. Reports issues to manager when found.
• Provide backup assistance to Medical Biller and Coder and other Accounts Receivable Specialists.
• Collect patient payments and submit refund requests as needed to manager for processing
• Works in multiple practice management systems, learning the different specialties offered by the company
• Responsible for finding and uploading explanation of benefits for claim payment posting
• Participates in all in-services and staff education competencies as needed.
• Exercises and maintains patient confidentiality by complying with all federal, state, and local statues or other agency regulations pertaining to confidentiality and a patient's right to privacy.
• Uses strict self-discretion and control in the disclosing of patient information to anyone at any time during or after leaving the CPH facility, except in accordance with all federal, state, and local statutes or other agency regulations and CPH policies and procedures relative to release of information and specifically, only to others who are directly involved with the patient's care or have a legitimate "need to know" to conduct his/her assigned CPH duties.

Minimum Qualifications: (Experience/Skills/Abilities/Education/Certifications):

• Strong communication skills, oral and written
• Must demonstrate the ability to multi-task while maintaining a high standard of confidentiality, as well as effective organizational and problem-solving skills.
• A minimum of a High School diploma.
• Three years’ experience working in hospital access, physician office or billing and collections.
• Knowledge of Medicare, Medicaid, Managed Care, Third Party Payer system including patient telephone contact and collections in a high-volume medical billing setting.

Preferred Qualifications: (Experience/Skills/Abilities/Education/Certifications):

• Some postsecondary education preferred.
• AthenaHealth EMR knowledge preferred
• Dentrix Enterprise knowledge preferred.

Physical Demands:

While performing the duties of this job, the employee is regularly required to stand; walk, often for prolonged periods; use hands to finger, handle, or feel; reach with hands and arms; stoop, kneel, crouch, or crawl; and see, speak, and hear. The employee must regularly lift and/or move up to 10 pounds and frequently lift and/or move up to 25 pounds.

Work Environment:

General office work : Role is currently hybrid, but could be onsite at any time as directed by leadership.

Supervisory Responsibilities: None 

Please note this position requires a background check to be completed. For details, please follow the link below:

FL Clearinghouse | Florida Agency for Health Care Administration

MINIMUM QUALIFICATIONS: (EXPERIENCE/SKILLS/ABILITIES/EDUCATION/CERTIFICATIONS):

• Strong communication skills, oral and written

• Must demonstrate the ability to multi-task while maintaining a high standard of confidentiality, as well as effective organizational and problem-solving skills.

• A minimum of a High School diploma.

• Three years’ experience working in hospital access, physician office or billing and collections.

• Knowledge of Medicare, Medicaid, Managed Care, Third Party Payer system including patient telephone contact and collections in a high-volume medical billing setting.

PREFERRED QUALIFICATIONS: (EXPERIENCE/SKILLS/ABILITIES/EDUCATION/CERTIFICATIONS):

• Some postsecondary education preferred.

• AthenaHealth EMR knowledge preferred

• Dentrix Enterprise knowledge preferred