The Accounts Receivable Collections Specialist is responsible for timely and accurate follow-up of health
insurance claims with various insurance companies. This will include researching authorizations,
working with the facilities and/or providers, managing denied claims in a timely manner, resubmitting
claims when necessary, review and appeal of denials or pending payer retractions, working assigned
accounts based on department policies and procedures. The position will also have responsibility to
backing up the EDI/Claims Specialist and Charge Capture Coordinator when needed for absences or
Daily follow-up of assigned A/R accounts assigned by facility/payer as outlines in work list.
Work all denials immediately base on assigned accounts to ensure timely response and to avoid
timely filing issues
Work collaboratively with peers to cover workloads, time off requests and special projects
Work cross-functionally with EDI/claims, charge coordinator, cash applications specialist and
Communicate all issues or potential issues to leadership
Meet KPI standards and follow all SOPs/Policies and procedures related to position and Revenue
Cycle Management compliance and payer standards.
Perform other office duties as assigned by manager.
High School Diploma or GED
Minimum of three years’ experience in Accounts Receivable collections or related functions
Proficient knowledge in reading and understanding insurance EOBs
Strong knowledge of payer rules, coordination
of benefits, collections and appeals process of claims
Proficient knowledge of ICD-10 and CPT-4 codes/
Comprehension of medical terminology
Familiarity with NCCI, federal and commercial insurance guidelines and policies preferred
Excellent written, verbal, and interpersonal communication skills.
Proficiency with Microsoft excel and word
Accurate and efficient data entry skills
Strong attention to detail
Proficient computer software and database skills.
Strong analytical skills.
Ability to multi-task and work in a fast paced, high volume environment.
Regularly required to sit 4-7 hours/day and stand 1-3 hours/day.
Intermittently required to stoop, bend, speak and listen.