The Accounts Receivable Specialist is responsible for the accurate and timely collection of claims and managing consumer accounts. This position will work independently and will be expected to be skilled in investigating unpaid claims with proper resolution of errors to obtain payment.
Job Responsibilities:
- Manage the comprehensive collection efforts for assigned payers
- Detailed investigation of unpaid claims and an understanding of proper escalation both internally and externally
- For patients with secondary insurance, submit claims as needed
- Collaborate with all internal team members to guide the AR recovery process effectively and efficiently
- Ensure effective communication with both internal and external stakeholders
- Interact daily with client team members to ensure accurate transfer of patient information for verification purposes
- Document all interactions with payers
- Adhere to all company policies and procedures
- Conduct business in a safe, compliant, and secure manner as it relates to HIPAA and patient privacy
- Other duties as assigned
Required Education and Qualifications:
- High School diploma or equivalent and 3-5 years of related work experience
- Knowledge of third-party payer requirements including federal, state, and Commercial
- Proven experience in healthcare billing, including Medicaid and Managed Care
- Experience with Raintree Systems is strongly preferred
- Knowledge of basic insurance policies, procedures, and reimbursement practices
- Prior experience with process development and execution
- Excellent communication and interpersonal skills
- Computer literacy as well as a working knowledge of various EMR platforms is a plus
- Microsoft Office, with a focus on Excel
The Practitioner Enrollment Specialist is responsible for all aspects of insurance enrollment related to Medicare, Medicaid, Private Insurance and Managed Care payers. Primary job functions include, but are not limited to:
GENERAL RESPONSIBILITIES:
- Complete and submit all enrollments with all applicable Medicare, Medicaid, Managed Care and Private Insurance payers
- Compile all necessary application information and attachments
- Maintain a Master List of all enrolled payers and renewal dates
- Work with client reimbursement personnel to ensure all applicable payers are enrolled as well as to resolve any claim denials associated with credentialing
- Track and manage applications thru the approval process
- Maintain all needed practice details for successful enrollment
- Responsible for providing high quality service to all clients as it relates to credentialing
- Promote ZMark Health services to existing and prospective clients
- Ensure effective communication with both internal and external stakeholders
- Interact daily with client team members to ensure accurate transfer of information
- Initiate communication with payers on behalf of our clients
- Document all interaction with payers
- Adhere to all company policies and procedures
- Conduct business in a safe, compliant and secure manner as it relates to HIPAA and patient privacy
- Other duties as assigned
POSITION REQUIREMENTS:
- High School Diploma or GED Required
- 3-5 years of experience in a Billing, Managed Care or Healthcare Environment
- Working Knowledge of MS Office
- Excellent interpersonal, written and verbal communication skills
- Must be able to work with minimal supervision
- Utilize effective time management principles, as well as work on multiple tasks simultaneously
- Demonstrated respect for confidentiality and compliance standards
- Ability to communicate effectively with staff at all levels as well as external stakeholders
