Accounts Receivable Specialist 2
New
J
JobgetherHealthcare Finance
Based in United StatesFull-TimeMiddle
Salary19 - 22 USD per hour
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Job Details
- Experience
- 2–3 years
- Required Skills
- Microsoft Excel
Requirements
- 2–3 years of experience in medical collections, denials management, and appeals processes.
- Experience handling complex denials, including DRG downgrades, level of care, coding, and medical necessity issues.
- Intermediate knowledge of ICD-10, CPT, HCPCS, and NCCI coding standards.
- Strong understanding of third-party billing guidelines and reimbursement processes.
- Knowledge of healthcare claim forms, including UB-04 and CMS-1500.
- Experience working with commercial and government payer contracts.
- Intermediate proficiency with Microsoft Word and Excel.
- Experience using healthcare information systems such as EMR platforms, claim scrubbers, and patient accounting systems.
- Knowledge of Medicare DDE claim systems and government healthcare regulations is a plus.
Responsibilities
- Verify eligibility and authorization information through payer websites, client systems, and direct communication with insurance providers.
- Update patient demographic and insurance details accurately within appropriate systems.
- Research unpaid, rejected, and denied claims to determine resolution strategies.
- Monitor claims for missing information, authorization details, and required control numbers.
- Review Explanation of Benefits (EOBs) to identify payments, adjustments, and opportunities for claim resolution.
- Contact insurance payers through phone and written communication to secure payments and manage reconsiderations or appeals.
- Access healthcare systems to review payment information, patient records, claims data, and related documentation.
- Obtain and submit necessary medical documentation requested by insurance carriers.
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