Accounts Receivable Specialist III #Full Time

61st Street Service Corporation; New Jersey; Remote; Full time

Job summary

A leading company offers the Accounts Receivable Specialist III position, primarily remote, requiring expertise in billing for transplant services. The role entails ensuring charges are billed correctly and timely, necessitating strong knowledge in billing practices and customer service skills. Candidates must have at least a high school diploma and experience in a physician billing environment.

Benefits

Healthcare benefits

Paid time off

Qualifications

• Minimum 2 years experience in a physician billing environment required.
• Strong customer service and patient-focused orientation needed.
• Knowledge of medical terminology and insurance contracts preferred.

Responsibilities

• Review and link transplant charges for appropriate billing.
• Ensure all demographic and insurance info is registered accurately.
• Contact insurers for the status of claims and appeals.

Skills

Customer service

Billing knowledge

Insurance navigation

Communication

Education

High school graduate or GED certificate

Tools

Epic

Electronic billing systems

Job description

Career Opportunities with 61st Street Service Corp

Current job opportunities are posted here as they become available.

Accounts Receivable Specialist III #Full Time

The 61st Street Service Corporation, provides administrative and clinical support staff for ColumbiaDoctors. This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors’ practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specialties and subspecialties.

This position is primarily remote, candidates must reside in the Tri-State area.

Note: There may be occasional requirements to visit the office for training, meetings, and other business needs.

Job Summary:

The Accounts Receivable Specialist III is responsible for reviewing critical data points to ensure all associated transplant charges are linked and billed appropriately to designated insurance carrier(s). Representative will ensure timely review and submission of charges following FPO policies and timelines. Responsibilities include follow-up efforts to collect on all open and unpaid accounts with insurance carrier(s).

Job Responsibilities:

• Through an assigned work queue, will follow protocols to review and resolve assigned prebilling edits to ensure appropriate claim submissions – charges are routed to the correct insurance carrier(s).
• Ensure the all demographics and insurance information is registered accurately and meeting all payer requirements.
• Confirm active insurance coverage and the filing order as well as linking coverage to the appropriate visits.
• Confirm all associated transplant services are properly reflected under the patient’s account.
• Releases transplant claims from pre-billing edits to allow for charge submission to the payers after all data points have been validated.
• Ensure any unbilled services / claims have updated and billed accordingly for payer adjudication.
• Must be in constant communication with New York Presbyterian (NYP) and/or departments to ensure transplant cases meet all criteria for proper charge submission.
• Addresses incoming correspondence and respond timely to ensure prompt resolution. Prepares correspondence to insurance companies, patient and/or guarantor, as necessary.
• Handles of complex and high dollar cases/accounts.
• Identifies, analyzes and reconciles billing errors or omissions.
• Applies strong working knowledge of all aspects of billing and collections including billing rules and regulations, collection practices, electronic billing processes, diagnosis and procedure coding, and applicable county, state, and federal requirements.
• Determines resolution, research root issue, apply knowledge of policies to pursue a course of appeal or follow up to obtain payment.
• Contacts insurance companies and/or patient/guarantor through phone contact, correspondence, online portals, and other approved means to obtain the status of outstanding claims and submitted appeals.
• Documents clearly in billing system the claim issue and course of action taken on every account worked. Documentation and action must be clearly noted for future follow up and review.
• Escalates billing problems toManager and payer contact as needed.
• Identifies trends or patterns of persistent problems.
• Performs charge corrections based on payer and institutional policies.
• Reviews account history for third party sponsorship.
• Assists supervisor/manager with monitoring work queues, producing basic ad hoc reports and other assigned functions.
• Handle complex and high-dollar cases/accounts.
• Determine resolution, research the root issue and pursue a course of appeal or follow-up to obtain payment.
• Address incoming correspondence and prepare correspondence to insurance companies, patient and/or guarantor.
• Contact insurance companies/patients/guarantors to obtain the status of outstanding claims and submitted appeals.
• Document claim issue and course of action taken.
• Elevate billing and collection problems to Supervisor as needed.
• Perform charge corrections.
• Review account history for third-party sponsorship.
• Assist supervisor/manager with any assigned functions.
• Assist with training support of new hires.
• Perform demographic/insurance coverage updates on the account and bill new insurance as appropriate.

Job Qualifications:

• High school graduate or GED certificate is required.
• A minimum of 2 years experience in a physician billing or third-party payor environment.
• Candidate must demonstrate the ability to understand and navigate contracts, insurance benefits, exclusions, and other billing requirements as well as claim forms, HMOs, PPOs, Medicare, Medicaid, and compliance program regulations.
• Candidate must demonstrate strong customer service and patient-focused orientation and the ability to understand and communicate insurance benefits explanations, exclusions, denials, and the payer adjudication process.
• Experience in Epic and or other electronic billing systems is preferred.
• Knowledge of medical terminology, diagnosis, and procedure coding is preferred.
• Previous experience in an academic healthcare setting is preferred.

Hourly Rate Ranges: $27.40 - $36.06

Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training, and education.

61st Street Service Corporation

At 61 st Street Service Corporation, we are committed to providing our clients with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a competitive comprehensive benefits package to eligible employees; including Healthcare and various other benefits including Paid Time off to promote a healthy lifestyle.

We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.