[Remote] Accounts Receivable Specialist

Note: The job is a remote job and is open to candidates in USA. Pinnacle Healthcare Consulting is a growing healthcare consulting company focused on professional billing for independent physician practices. The Accounts Receivable Specialist role involves supporting billing services, investigating outstanding claims, and providing customer support while ensuring compliance with regulatory standards.

Responsibilities

• Accountable for outstanding customer service to all external and internal
• Develops and maintains effective relationships through effective and timely communication
• Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner
• Maintain up-to-date patient demographics and insurance information
• Identify errors through coding, charge entry and cash application processes
• Complete daily denials by working with insurance companies and adjusters to resolve problem accounts, re-file and re-open claims, file appeals and make decisions on adjustments
• Investigate and work claims based on aging from date of service
• Refer refund request to refund specialist
• Provide first level customer service support for billing services including answering patient’s questions and researching account issues. Assist with customer’s pending items including charges, payments and denials and follow-up to confirm these items are resolved
• Document activity in an accurate and timely manner on the patient’s account
• Review and prepare accounts for collections
• Complete and communicate progress on assigned tasks to Manager
• Maintain proficiency and an appropriate level of knowledge with all systems required for task completion
• Ensure compliance with all state and federal billing regulations, including HIPAA, and report any suspected compliance issues to the respective Manager or RCM leadership
• Work with RCM management team to improve processes, increase accuracy, create efficiencies and achieve the overall goals of PHRS
• Other duties as assigned

Skills

• High School diploma or equivalent is required
• Minimum 2 years of experience in medical billing or has graduated from an accredited medical college
• Candidate must understand government and managed care payment methodologies and demonstrate knowledge of terms such as contractual adjustment, allowed amount, coinsurance, denial and denial processes
• Required to stay until 6:00 PM EST approximately one time every six weeks, in rotation, with other AR Specialists in order to cover customer service lines
• Knowledge of business office procedures
• Ability to establish and maintain an effective working relationships with patients, physicians, client practice staff, and co-workers
• Ability to operate a computer, copier or fax machine
• Ability to sort and file materials correctly by alphabetic or numeric systems
• Verbal and written communication skills
• Knowledge of Microsoft Office Products
• Associates Degree or higher in Medical Billing and Coding or a related field is preferred. A degree is not required if candidate has at least 2 years of prior billing experience in a physician practice medical billing environment
• Experience in billing or health insurance claim processing preferred
• CPT, ICD-9, and HCPCS coding knowledge preferred
• Experience in one or more of the following billing software platforms is preferred - EPIC; Ideal; Allscripts; Centricity; Acumen-Epic; iSalus; Athena
• Experience in one or more of the following specialties is preferred – Nephrology; OB/GYN; Gastroenterology; Internal Medicine; Long Term Care

Benefits

• Medical
• Dental
• Vision
• STD
• LTD
• HSA (as applicable with Employer contribution)
• 401k Plan with employer match

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