Accounts Receivable Specialist

Description

 Job Description  

The Accounts Receivable Specialist (ARS) records charges and payments to client accounts and maintains accounts receivable records. The Specialist works with third party agencies on unpaid and/or denied claims. The Accounts Receivable Specialist completes physical/psychiatric billing. The ARS also regularly meets with clients to review insurance coverage and other financial information. 

Roles & Responsibilities

A/R Services:

• The ARS submits/resubmits HCFAs to third-party payer sources and uses the Nebraska Medicaid Electronic System (NMES) line to check client coverage.
• Consistently communicates/investigates concerns related to payer performance, system functionality and any other identifiable barriers to performance thus negatively influencing the organizational goals and metrics. 
• The ACR is responsible for the physical and psychiatric billing.
• The Accounts Receivable Specialist will research/analyze third party claims thoroughly, timely, and accurately and responds to all inquiries and/or denials of claims in an efficient and effective manner. The ARS will also perform follow up inquiries via telephone, secure third-party portals, or secure email for outstanding/unpaid claims according to department guidelines. 
• The Accounts Receivable Specialist will meet with clients to conduct financial interviews, verify client insurance/other payer benefits and post client charges and payments.
• The ARS communicates with the clients regarding account changes/updates including changes in insurance and/or income.
• Documents clear, concise, complete, and accurate notes in the client account regarding claim status. 
• Develops relationships with outside provider offices/facilities and across BHS. 
• Assists with Credentialing tasks as assigned. 
• Makes collection calls, as assigned.
• Creates journal entries through the E.H.R system, as assigned. 
• Assists with related special projects, as required.
• Provides back-up coverage for other Accounts Receivable, Records staff members. 

Requirements

 Other Requirements

• Successful completion of background checks/references including a valid driver’s license. The driving record must be in accordance with the agency’s guidelines. 
• Must be at least 21 years of age.
• If in lived substance abuse recovery, two years of continuous sobriety/ “clean time” is required and maintained throughout employment. 
• Willing to obtain a flu shot annually (except for those allergic to the vaccine or who have a religious exception) or must wear a mask when agency deems appropriate due to times of high illness.
• Must comply with agency policies and procedures, including those regarding conduct, confidentiality, and record keeping.
• High school diploma or general education degree (GED). Associates degree and/or certification in medical billing/medical coding preferred, or equivalent combination of education and experience. Experience in Behavioral, Physical and Psychiatric billing preferred. 

Knowledge, Skills, and Abilities (Competencies): To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The Knowledge, Skills, and Abilities (Competencies) required are listed below:

· The ARS will have knowledge of Behavioral, Physical and Psychiatric billing. 

· The ARS will possess excellent organizational, time management, and attention to detail skills with the ability to multitask and compartmentalize when faced with many interruptions. 

· The Accounts Receivable Specialist must have strong oral communication skills with the ability to influence medical professionals, payer sources and clients through developing relationships while using assertive communication.

· The ARS must have strong critical thinking skills with the ability to apply emotional intelligence when problem solving. 

· Knowledge and understanding of 42 CFR confidentiality laws regarding management of records is required.

· The ARS will have knowledge of the agency policies and procedures, with the ability to understand and implement the agency P&P expectations. 

· The Accounts Receivable Specialist can answer a multi-line phone system in a professional manner and direct callers appropriately. The ARS possesses basic computer knowledge to navigate email, spreadsheets, and the agency E.H.R system. The ARS can operate accounting software, Microsoft Word and excel programs.