What are the responsibilities and job description for the Accounts Receivable Specialist - Healthcare position at Family Centers?
Overview
Family Centers seeks a detail-oriented Accounts Receivable Specialist to support the Revenue Cycle team in managing outstanding accounts receivable. The incumbent will ensure timely and accurate reimbursement for services rendered by researching denials, appealing underpaid claims, resolving payment issues, and maintaining compliance with billing standards.
The Role
Claims Management: Review and resolve outstanding claims and encounters in assigned Epic work queues to ensure timely payment.
Denial & Zero Pay Review: Respond to denials, zero pays, and payer correspondence within two business days. Identify the root cause and initiate resubmissions or appeals as appropriate.
Appeals & Payer Communication: Submit appeals for denied or incorrectly processed claims through payer portals or phone communication. Follow up until resolution is achieved.
Payment Posting Coordination: Work collaboratively to resolve Explanation of Benefits (EOB) discrepancies and ensure accurate posting of payments and adjustments.
Patient Balance Resolution: Investigate and address outstanding patient balances in accordance with policy and compliance standards.
Credit Balances: Identify, research, and resolve patient credit balances. Process refunds when necessary.
A/R Trend Analysis: Identify trends in denials or payment delays and escalate recurring issues to the Revenue Cycle Director for resolution planning.
Productivity and Documentation: Utilize Epic dashboards to track progress. Meet productivity benchmarks and document all actions clearly in the system.
Compliance: Ensure all activities are conducted in compliance with HIPAA and internal confidentiality standards.
Other duties as assigned
Requirements
- High school diploma or equivalent
- Minimum 2 years of experience in medical billing, insurance follow-up, or revenue cycle management
- Proficiency with Epic or similar EHR systems
- Strong understanding of CPT, ICD-10, and HCPCS codes
- Familiarity with EOBs, denial codes, and appeals processes
- Demonstrated proficiency in billing software and payer portals
- Excellent problem-solving, communication, and organizational skills
- Ability to work on tasks independently and also in a collaborative team environment
- Must maintain patient confidentiality and adhere to HIPAA regulations
- Able to manage multiple tasks and meet deadlines in a fast-paced environment
Preferred
- Associate degree or higher in healthcare administration, business, or related field
- Certifications such as CRCS, CPB, or CMRS
About Family Centers
Family Centers is a private, nonprofit organization offering health, education and human service programs to children, adults and families in Fairfield County. Our team includes 300 professionals and over 500 trained volunteers who collaborate to provide our communities with a wide range of responsive and innovative services. Through our comprehensive network of services, more than 23,000 children, adults, families and communities receive the care, encouragement and resources needed to realize their potential.
Rewards
Salary commensurate with experience. A suite of benefits includes generous paid time off, medical, dental, vision, tax-free spending accounts, disability, life and AD&D insurance. Additional benefits include an employee assistance plan, pet insurance, critical accident and illness, wellness services, tuition assistance, and retirement savings. The opportunity to work for an employer consistently rated one of the Top Workplaces in Western Connecticut by Hearst Connecticut Media and a perfect 100 Encompass rating by Charity Navigator.
To Apply
Visit http://www.familycenters.org/ or find us on LinkedIn.
Family Centers is committed to providing equal employment opportunities to all applicants and employees as indicated in applicable federal and/or state laws.
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