AR (Account Receivable) Collectors - Medical

Decision Wave; Alpharetta (GA); On-site; USD 40,000 - 55,000; Full time

Job summary

Decision Wave is seeking AR (Account Receivable) Collectors in Alpharetta, Georgia. The role involves performing follow-ups on insurance receivables and resolving account issues while adhering to key performance indicators.

Candidates should possess excellent knowledge of billing procedures, be able to analyze claim responses, and communicate effectively to resolve outstanding balances. This position promotes teamwork and engagement with diverse work environments.

Qualifications

• Experience in account receivables follow-up and resolution functions.
• Demonstrated knowledge of billing procedures and claims processing.
• Ability to communicate effectively and correct billing issues.

Responsibilities

• Perform account receivables follow-up and resolution.
• Analyze and take action on insurance claims responses.
• Communicate with leadership regarding billing problems.

Skills

Knowledge in liaising with healthcare insurance companies

Ability to analyze 835 and 277 claim responses

Ability to deflect calls by proper analysis

Knowledge in writing appeals

Prioritization of claims

Basic knowledge of the entire RCM process

Job description

AR (Account Receivable) Collectors - Medical

Job Description

Responsibilities for the role include:

• Performs account receivables follow-up and resolution functions of insurance receivables in a manner that meets or exceeds key performance indicator (KPI) criteria.
• Demonstrates knowledge and understanding of standard bill forms, electronic claims submission with filing requirements and claims processing and query systems; serves as subject matter expert in assisting collection and payer team and escalates as appropriate to secure payment on outstanding account balances.
• Recognizes and identifies billing problems and payer trends from EOBs and communicates effectively with leadership to correct errors/trends in a timely manner. Updates the account record to identify actions taken.
• Shows ongoing enthusiasm and commitment to assigned work while practicing and adhering to HIPAA standards, the “Code of Conduct” philosophy and the company and client “Mission and Value Statement.”
• Works effectively within a team and participates constructively to produce results; receives feedback from supervisor to create a personal development plan.

Technical Competencies (Job Related)

• Knowledge in liaising with healthcare insurance companies on behalf of health system/providers and following up on outstanding AR.
• Ability to analyze 835 and 277 claim responses and take necessary action.
• Ability to deflect calls by proper analysis.
• Knowledge in writing appeals and following through the appeals process.
• Prioritizes pending claims from aging basket and follows up at regular intervals to collect outstanding balances.
• Resolves accounts to get paid with a maximum of two touches.
• Checks appropriateness of insurance information and follows up with patient as needed.
• Escalates difficult collection situations to management in a timely manner.
• Possesses basic knowledge of the entire RCM process.
• Identifies trends and patterns for better resolving accounts and generates payments in bulk.

Equity, Diversity, and Inclusion

All your information will be kept confidential according to EEO guidelines.