Accounts Receivable Specialist

Sound Retina

Job Description – Payment Poster/ AR Specialist

Position: Payment Posting – AR Specialist

Summary of Duties: Specialist is responsible for entering payments received on accounts. Responsibilities include posting the payments by line item, taking appropriate adjustments, and balancing and reconciling monies received. Identify problems and issues on accounts, sending information to the appropriate team member to be worked.

Specialist will work assigned work queues and work lists to ensure timely reimbursement for Sound Retina. Insurance A/R Specialist will work denials, correcting issues, and resubmitting the claim for payment. Denial patterns and issues will be reported to management for review. Specialist will file and track appeals of denied claims when required. Specialist is responsible for working denials and filing appeals in a timely fashion.

Supervision: Reports to the Director of Finance and Business Services.

Essential Duties:

• Responsible for posting insurance payments to the correct accounts, taking the appropriate contractual adjustments as necessary. Transfer of balance as appropriate to secondary insurance or patient responsibility. This includes posting “zero” payments or “no pays” to accounts with a message or comment and moving the balance as appropriate.
• Responsible for posting patient payments to the appropriate accounts.
• Runs and analyzes balancing report to ensure accurate posting. Reconciles cash batch while supporting department cash control policies and procedures. Must print batch report and file all documentation appropriately.
• Meets monthly close deadlines.
• Assists with payment and adjustment questions and conducts research if necessary.
• Work as a liaison with the lockbox vendor/bank and to ensure processes and scanning is timely, clear, and accurate. Discuss any issues with the Administrative Assistant and/or Director of Finance and Business Services.
• Responsible for flagging explanation of benefits with problems to be provided to the Insurance A/R Specialist for follow up. Interaction may be required with Insurance A/R Specialist concerning problem accounts, such as those that have been appealed, to ensure correct posting of additional payment/adjustments.
• Responsible for printing/submitting secondary claims as needed, attaching primary explanation of benefits, and sending to secondary insurance (applicable for insurance companies that still accept paper secondary claims). Some secondary claims may need to be filed through the payer portal.
• When posting an insurance credit balance, provide the documentation to the Insurance A/R Specialist for review to determine if a refund is required.
• Demonstrates knowledge of insurance payer guidelines and internal collection guidelines.
• Completes tasks accurately while maintaining quality and production standards.
• Works accounts receivable aging reports as assigned and perform follow up in a timely manner on claims. Includes working denials and correspondence received with an expected 48 hour (2 business day) turn around. Work is to be documented in the practice management system.
• Research credit balances and write up request with documentation for refunds to be approved and issued. Gives refund request to Refund Coordinator for processing.
• Appeals incorrectly paid and denied claims in a timely fashion with the appropriate insurance. May require regular telephone contact or meeting use of the payer’s portal for resolution of issues and payment of claim.
• Completes review of A/R assigned in a timely fashion. Recognized trends within that A/R, keeps management informed, while seeking resolution of issues involved.
• Responsible for resolving error reports from the clearinghouse in a timely manner. Error resolution means that a claim was successfully submitted to the patient’s payer for payment. Utilize the reporting functions from the clearinghouse, understanding and reporting to management on trends and issues that are identified through this process. Will also work any error report identified in the practice management system to ensure all claims are going out for payment.
• Helps answer patient billing questions, in person, email or by phone, when necessary.
• May assist with updating patient demographics and insurance information as needed.
• Keeps abreast of all billing, trade and coding publications using the appropriate sources (internet, seminars, publications, etc). Disseminates the information to the appropriate staff within the practice in a timely fashion.
• Works on special projects as requested by the Director of Finance and Business Services, Executive Director, or Physicians.
• Represents Sound Retina in a professional manner related to appearance, communication, and the maintenance of patient confidentiality. Supports the objectives and goals of the practice.
• Attends seminars and training as required by practice. Travel may be required.
• Performs other duties as directed by leadership. Other duties as assigned.

Qualifications:

1. High school diploma with some college preferred.
2. Minimum two years billing and medical collections experience, using a practice management billing system.
3. Ability to work quickly and accurately, with attention to detail.
4. Good organizational and multi-tasking skills. Good oral communication skills.
5. Able to demonstrate independent judgment and initiative.

• Ability to perform physical tasks of job, including but not limited to lifting 20-pound boxes and bending over.
• Able to demonstrate independent judgment and initiative appropriately