Medical A/R Collections Specialist

Summary Responsible for all aspects of Medical A/R collections, claim status and denial management.

Essential Duties and Responsibilities include the following. Other duties may be assigned as needed to meet our department productivity standards.

• Completes follow up on outstanding medical A/R insurance claims with no response directly with payers
• Works various denials from insurances including coverage in question, medical necessity, re-bundled, incorrect coding, credentialing, etc.
• Reviews electronic rejections
• Completes incoming correspondence from patients and or insurance
• Works with coders on any coding and billing issues to correct and or appeal errors in a timely manner
• Initiates refund/credit requests.
• Properly documents the patient account of all steps taken to resolve balance pending by payer or patient
• Escalate problems with electronic claims submissions and or bulk rejections to manager for assistance and guidance for resolution.
• Bulk mails all manual claims to individual payers daily as needed
• Works daily, weekly and monthly aging reports as assigned