Job Description

This position is responsible for timely follow-up of assigned claims that have been rejected or denied.  Effective analysis and resolution of accounts receivable are based on third-party claim processing guidelines and established policies and procedures.  The Accounts Receivable Specialist reports to the AR Manager.

  • Works all reports related to outstanding claims, such as worklists, hold reports, and rejection reports to ensure claims are corrected and submitted/resubmitted timely and accurately, per payer guidelines and Steward Medical Group policies;
  • Appropriately analyzes denials and scrubs for root causes, and takes necessary steps to resolve;
  • Identifies issues and trends, and effectively communicates related data to leadership for assessment of potential systems or workflow improvement;
  • Accesses and completes any documentation necessary for timely billing/rebilling of patient claims, including requesting or retrieving medical records and other attachments to ensure the payer’s acceptance of the claims;
  • Processes and files claims for secondary billing, attaching all required documentation to ensure claims are reimbursable by applicable payers;
  • Understands and complies with all payer guidelines related to claim submission; is knowledgeable and proficient with payer websites and other useful resources pertaining to the billing function;
  • Focuses daily on complying with policies, procedures, and department guidelines for billing and claim edit resolution; and
  • Maintains strict confidentiality and adheres to all HIPAA guidelines/regulations.


Qualifications

  • Knowledge of basic medical coding/terminology and third-party insurance operating procedures and practices a plus;
  • Knowledge of revenue cycle and/or business office procedures;
  • Highly detail-oriented and well-organized;
  • Ability to read, understand, and follow oral and written instructions;
  • Ability to establish and maintain effective working relationships and communicate clearly with customers and insurance companies both within and outside of Steward Health System;
  • Medical billing and coding certification a plus; and
  • Experience with medical billing software - athenaNet preferred

Application Instructions

To apply directly to Steward Health Care, please click the link below. Another window will open and allow you to apply directly online.

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