This position is located at the Birmingham Business Office

Summary: Under general supervision, an AR Account Follow-Up Specialist is responsible for account follow-up for all assigned accounts, resolving billing problems and answering patient inquiries. Uses collection techniques to keep accounts receivable current including monitoring for delinquent payments. The Account Follow-Up Specialist will review insurance claims and take the appropriate action, including completion of submissions, reconsiderations, appeals, or re-working denials, to ensure payment is received timely.

Essential Duties and Responsibilities:

• Performs audits of patient accounts to ensure accuracy and timely payment.

• Reviews account aging monthly and reports inconsistencies and correct errors as appropriate.

• Follows up on insurance billing to ensure timely receipt of payments.

• Demonstrates the ability to deal with patients and insurance companies regarding sensitive financial matters and recapture unpaid balances.

• Receives and resolves patient billing complaints and questions; initiates adjustments as necessary; follows up on all zero payment explanations of benefits and exercises all options to obtain claim payments.

• Reviews credit balance reports for correct recipient of refund.

• Performs reconciliation of refund accounts; attaches documentation and forwards to supervisor to process refund checks.

• Identifies problems on accounts and follows through to conclusion.

• Responds to insurance companies requests for information in a prompt and professional manner.

• Reviews appropriate files to identify deceased patients and estates; verifies dollar amounts and files estate to appropriate court in a timely manner.

• Reviews EOBs to ensure proper reimbursement of claims and reports any problems, issues, or payor trends to supervisor.

• Resubmits insurance claims within 72 hours of receipt.

• Participates in maintaining Payor Manuals/Profiles.

• Works closely with collection agency to assure that they receive updated information on accounts as necessary.

• Prepares write-off requests with appropriate documentation and submits to supervisor.

• Processes insurance/patient correspondence, including denial follow-up within 48 hours of receipt. Files all reimbursement correspondence daily.

• Works with provided aging to monitor patient account aging and follows up appropriately.

• Maintains confidentiality in regard to patient account status and the financial affairs of clinic/corporation.

• Other relevant duties as assigned

• Must possess a comprehensive knowledge of revenue cycle functions and systems, physician practice revenue cycle operations, revenue metrics and analytics.

• Must have strong management and leadership skills that emphasize team building and collaboration. Not afraid to jump in and help with backlogs or projects.

• Excellent communications skills, written and verbal with ability to provide clear direction to staff as well as presentation skills.

• Proficient with computers and their applications including EMR's, Practice Management systems, databases, and Microsoft Office products such as Outlook, Excel, and Word.

• Have a track record of leadership success in healthcare revenue cycle management.

• Demonstrated knowledge of the federal, state, and local regulatory requirements around medical billing and coding as well as CMS and payer regulations.

• Ability to work independently.

• Able to manage multiple projects at once, ability to work efficiently and effectively under tight deadlines.

• Demonstrates advanced analytical, evaluative, problem solving and decision-making, fostering innovative approaches to situations/processes/issues.

• Strong collaborative leadership qualities, willing to work side by side with staff when “hands on” approach is needed.

• Experience in a complex healthcare organization preferred with oncology experience highly desirable.

Requirements

• Bachelors (preferred) in healthcare, accounting or related field or a high school graduate

• 3 plus years of experience

• Experience in medical billing /insurance processing and balancing accounts

Company Benefits

• Family/Work balance Monday - Friday work schedule

• Company Holidays

• Company Vacation

• Excellent Medical with vision included.

• Excellent Dental

• Free parking

EOE