The primary responsibility of the AR Specialist is to actively work assigned clients accounts receivable, and rapidly respond telephone inquiries from patients.
Works and coordinates with RCM to ensure smooth and efficient operation in all areas of accounts receivable
Works necessary reports to ensure assigned client AR is actively worked & maintained
Serves as client/patient support to assigned clients
ACCOUNTS RECEIVABLE RESPONSIBILITIES
Works Denials Daily
File Rejected
Denial Report
In Progress Non-Primary
Sent Secondary Crossover
Review Bad Address report weekly
Update patients address in Centricity when report provides updated information
Those without new information, send list to practice contact with MRN # advise mail being returned need update, or log-in to EMR, any changes or updates then made to the patients account in Centricity.
Bill Status Report Hold Charges
Reviews charges on hold weekly, and coordinates with charge processor to ensure timely release of charges to avoid untimely filing
CLAIM SUBMISSIONS/CORRECTIONS
Will review, prepare, and submit claims to third party payers (primary and secondary) according to established policies and procedures
DEMOGRAPHICS
Will retrieve, review, verify benefits, and update new insurance information as needed
Move demographic files to GeBBs daily for assigned clients
Sign-off on Daily Client Charge Log for demographics;
Sign-off on Month-end Log by 5th business day of the month
CORRESPONDENCE
Receives and processes miscellaneous correspondence from patients, insurance companies and clients within 48 hours
Accounts Receivable follow-up
Pulls EOB's
REFUNDS
Will actively review, prepare submit;
Refund requests
Account adjustments
COLLECTIONS
INSURANCE COLLECTIONS
Run Stop report monthly. The STOP report is used to identify, and facilitate successful collection of both patient and unpaid insurance claims upon completion of patients course of treatment
Identify unpaid claims, and set reminders to actively work to a successful conclusion
Monitor patient balances, and actively move through collections process including setup payment arrangements
AGING REPORTS/COLLECTION EFFORTS EXHAUSTED
Aging by Financial Class, Patient
And any other reports identified to assist in this process by RCM
PATIENT COLLECTIONS:
Will review, prepare and submit patient supplemental bills to patient(s)
Assist with payment arrangements
Identify Self-pay patients for assigned clients;
verify monthly eligibility with Medicaid
follow-up with practice charity status
Assists in processing credit card payments from patients
Maintain current list of medical policies for the various procedures, and or diagnosis covered by those entities
Ensure all corporate guidelines are maintained and practiced daily
Maintain a "Team Player" attitude at all times
Communicate professionally with management, Offshore, and peers
