ACCOUNTS RECEIVABLE SPECIALIST

Riverside Healthcare

Kankakee (IL)

On-site

USD 33,000 - 41,000

Full time

44 hours ago

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Benefits offered by this job

Health insurance

Paid time off

Retirement plan

Educational assistance

Job summary

Riverside Healthcare in Kankakee, IL is seeking an Accounts Receivable Specialist to pursue reimbursement and resolve outstanding claims. You will follow up on denials, appeal claims, and communicate with insurance carriers to achieve timely payments.

The role requires at least 2 years of related experience, strong organization, HIPAA knowledge, and proficiency with Microsoft Office and practice management systems. Epic experience preferred. Competitive benefits offered.

Qualifications

Minimum 2 years of related AR/billing experience.
Detail oriented with strong organizational skills.
Working knowledge of insurance rules and HIPAA standards.
Proficient with Microsoft Office and Excel.

Responsibilities

Resolve insurance denials and follow up on open accounts to drive timely payments.
Appeal claims and respond to carrier inquiries in a compliant manner.
Update registrations, post denial codes, and adjust in PM systems.
Communicate effectively with patients, coworkers, and professional offices.

Skills

Accounts Receivable

Insurance follow-up

Denials management

HIPAA compliance

Microsoft Excel

Communication skills

Education

High school diploma

Two years of college

CPC/CCA certification preferred

Tools

Epic

Practice management systems

Job description

Overview

The responsibilities of an Accounts Receivable Specialist is to pursue reimbursement of services rendered and achieve accounts receivable resolution. specific tasks include resolving insurance carrier denials, appealing claims, contacting carriers on open accounts and responding to insurance carrier correspondence and/or inquiries.

Essential Duties

Consistently meet or exceed current productivity and quality standards in a timely resolution of all claim edits, reporting of candidates for bill, outbound complaint claim submission, clinical documentation requirements and any other communication required (verbal or written) regarding claims ensuring timely filing of claims and clean, complete and accurate claims
Timely follow-up on denials and appeals, including root cause analysis to reduce/prevent future denials while working to overturn denials for payment resolution.
Compliant follow‑up correspondence to third party payers regarding outstanding accounts receivables (i.e., Statements, letters, emails, faxes, portal mail, etc.).
Understanding of payer types (i.e., Managed Care, Commercial, Medicare, Medicaid, Replacement plans, Workers' Compensation, Corporate Accounts, Research, and Specialty AR Accounts).
Understanding of payer Medical Reimbursement policies.
Update registration information, post denial codes and adjustments in practice management systems.
Recommend accounts for contractual or administrative write‑off and provide appropriate justification and documentation.
Practice HIPAA privacy standards and ensure compliance with patient health information privacy practices.
Identify opportunities for customer, system and process improvements and submit to management.
Follow the Riverside Healthcare general policies and procedures, the department policies and procedures and any emergency preparedness procedures.
Assist with special projects and other duties as assigned, as necessary.

Responsibilities

Required Experience

At least 2 years of related work experience
Detail oriented, good organizational skills, and ability to be self‑directed.
Working knowledge of physician billing and follow up, including an understanding of insurance rules and regulations.
Knowledge of HIPAA standards.
Ability to perform mathematical calculations.
Excellent communication skills when dealing with patients, families, public, co‑workers, and professional offices.
Basic knowledge of medical terminology and billing practices.
Extensive experience and knowledge of PC applications, including Microsoft Office and Excel.

Preferred Experience

Knowledge of Epic systems.
Three or more years of progressive work experience in a hospital/physician billing or SBO

Required Licensure/Education

High school graduate or equivalent

Preferred Education

Two years of college or college degree
Physician coding certification (CPC through AAPC or CCA through AHIMA) preferred

Our Commitment to You:

Riverside Healthcare offers a comprehensive suite of Total Rewards: benefits and nationally rated employee well‑being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more so your journey at and away from work is remarkable.

Compensation

Base compensation within the positions pay range based on factors such as qualifications, skills, relevant experience, and/or training
Premium pay such as shift differential, on‑call
Opportunity for annual increases based on performance

Benefits - .5 to 1.0 FTE

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short‑and‑Long‑Term Disability
Health Savings and Flexible Spending Accounts for eligible health care and dependent care expenses
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Benefits - .001 to .49 FTE:

Paid Leave Hours accrued as you work

Employee Health Requirements

Exposure to:

Chemicals: None
Video Display Terminals: Average
Blood and Body Fluids: Performing ER and Admitting registrations have the potential to be exposed.
TB or Airborne Pathogens: Performing ER and Admitting registrations have the potential to be exposed.

Sensory requirements (speech, vision, smell, hearing, touch):

Speech: Required to communicate during presentations/training, telephone communication, and facilitate meetings.
Vision: Needed to read memos and literature, close vision (ability to adjust focus).
Smell: NA
Hearing: Needed for telephone communication, meetings, alarms and listening to employee concerns.
Touch: Needed to write, computer entry, filing.

Activity/Lifting Requirements:

Percentage of time during the normal workday the employee is required to: