As an accounts receivable specialist you will be primarily responsible for one of the following accounts receivable functions: medical billing, cash applications, processing credits, or coordinating the electronic fund transfer process. You may also be cross trained in one or more of these accounts receivable functions.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
- Maintain and document complete, timely, and accurate billing information for assigned products.
- Perform on-going reconciliations’ to ensure the integrity of the billing/receivables data.
- Review all claims for accuracy and completeness
- Prepare and process billing for primary billing and secondary billing utilizing CM 1500 claims processing form.
- Process EDI billing utilizing electronic billing system (e.g. Blue Cross of Tennessee, Medicare, Medavant)
- Research and correct rejected claims for resubmission.
- Process incoming cash receipts (lock-box, in house, credit cards) against appropriate accounts.
- Research all discrepancies in amount billed versus amount paid. Determine why discrepant and next action required.
- Balances cash receipts to the general ledger daily.
Electronic Funds Transfers (EFT)
- Process credit memos/debit memos on line to rectify billing discrepancies. (i.e., pricing, incorrect customer billed sales and commission corrections, etc.)
- Process credits for returned merchandise from domestic customers.
- Research and analyze problems for credit and rebilling requests.
- Review credits and re-bills daily for accuracy and distribute to appropriate for special handling.
- Coordinate process to set up payers for electronic fund transfers.
- Conduct system testing before final implementation of the EFT process with each payer
- Pull EFT’s , back up documentation and submit for cash applications processing.
QUALIFICATION REQUIREMENTS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION and/or EXPERIENCE:
medical billing (electronic and hard copy),
- Have an associate’s degree and a minimum of 2- 3 yrs exp in one or more of the following accounts receivable functions:
cash application processing,
Electronic fund transfer implementation and processing
- Candidates without an associate’s degree 4 – 5 years of experience in one or more of the accounts receivable functions listed above.
- Have experience with CMS 1500 claims process.
- Have working knowledge of medical coding, insurance terminology, and documentation requirements. (CPT and ICD9 codes)
- Be highly motivated and detail oriented.
- Have good communication (verbal and written), analytical and organizational skills.
- Have ability to handle a heavy workload.
Proficient in the use of Microsoft Office (outlook, word and excel) or similar software is required.
Proficient with using integrated software applications. (SAP experience preferred).