JOB TITLE:  Accounts Receivable Specialist

GENERAL SUMMARY OF POSITION:  Responsible for the review and follow-up on accounts to ensure timely payment from insurance or patients.

SUPERVISION RECEIVED:  Reports to Billing Manager

SUPERVISION EXERCISED:  None

ESSENTIAL FUNCTIONS:

1. Read and understand Explanation of Benefits from various insurance companies. Follow-up with insurance companies and ensure claims are paid. 
2. Appeal payer denials per protocol.
3. Identifies and resolve patient billing inquiries to ensure quality patient service.
4. Posting payments and charges to accounts, as needed.
5. Review and analyze AR reports incorporating payer payment guidelines to resolve accounts effectively.
6. Review and resolve account balances ensuring payment is received.
7. Participates in staff educational activities as requested. Keeps current with health care trends and practices.
8. Other general office duties as assigned by Billing Office Manager.

EDUCATION:  High School Diploma

EXPERIENCE:  Minimum of one year accounts receivable experience, preferable within a health care organization. Employment within a health insurance company with similar duties may be substituted. Additional education and/or general office experience is beneficial.

CERTIFICATES AND LICENSES: 

QUALIFICATIONS (Knowledge, Skills, and Abilities):  The job holder must demonstrate current competencies applicable to job position including but not limited to:

1. Ability to collect on delinquent accounts with payers or patients.
2. Knowledge of the Fair Debt Collection Practices Act.
3. Knowledge of computer systems, programs, applications.
4. Knowledge of medical terminology, CPT and ICD-9 Codes, modifiers.
5. Knowledge of medical billing/collection practices.
6. Knowledge of HIPAA guidelines.
7. Knowledge in medical coding.
8. Skill in general office procedures, data entry/ten key, telephone etiquette.
9. Good oral and written communication.
10. Skill in gathering, analyzing, and evaluating data.
11. Excellent customer service skills are required.
12. Knowledge of payer guidelines.

ENVIRONMENTAL/WORKING CONDITIONS:

Position is within a normal business office environment. Position involves frequent contact with staff, patients, and the public. Work may be stressful at times. 

PHYSICAL/MENTAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is occasionally required to stand; walk; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear. The employee will be sitting 6-8 hours a day. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. This position requires the use of computer equipment and extensive use of the telephone.

FLSA DESIGNATION: Non-exempt

This description is intended to provide only basic guidelines for meeting job requirements Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

Charlotte Gastroenterology and Hepatology P.L.L.C. is an equal opportunity employer.