AR Specialist

The Role

The Accounts Receivable Specialist plays a crucial role in our revenue cycle management team, dedicated to ensuring the accurate, compliant, and timely billing and reimbursement of multi-specialty medical professional services from diverse insurance payers and patients. This pivotal position involves meticulous attention to detail in the collection of unpaid patient accounts, setting and achieving specific goals, proficiently managing re-billing, payment posting, contractual write-offs, adjustments, and appeals in accordance with multi-state and federal insurance regulations. The ideal candidate will demonstrate a strong commitment to maintaining revenue integrity while upholding the highest standards of professionalism and compliance.

Key Responsibilities

• Prepare and accurately resubmit comprehensive corrected claims to various insurance companies, adhering closely to specific payer guidelines and contractual requirements, both electronically and via paper submission.
• Conduct thorough analysis of first pass rejected claims, ensuring completeness and accuracy of information for subsequent clean claim submission, thereby minimizing delays in reimbursement.
• Perform diligent research and follow-up on the status of primary and secondary billing claims for assigned insurance plans, proactively resolving any outstanding issues to expedite payment.
• Review, assess, and process all claim appeals, meticulously resubmitting to insurance carriers with comprehensive and accurate supporting documentation to maximize reimbursement.
• Evaluate customer accounts and recommend adjustments or write-offs to the Manager based on the collectability of accounts with insurance carriers or patients, maintaining a balanced approach to revenue recovery.
• Identify and promptly report any billing problems, errors, or discrepancies to management, facilitating proactive resolution of billing trends and ensuring ongoing revenue integrity.
• Generate and distribute monthly patient balance due statements in accordance with the explanation of benefits received from insurance carriers, fostering transparent communication, and facilitating timely resolution of outstanding balances.

Minimum Requirements

• One to three (3) years of experience in medical insurance claims billing and collections preferred.
• Proficient in Google for Business, MS Office, Excel and Word.
• Experience with physical therapy EMR systems is a plus.
• A customer success-oriented attitude.
• Excellent communication and negotiation skills.
• Problem-solving aptitude.

HIPAA Requirements

All associates are required to comply with the Health Insurance Portability and Accountability Act (HIPAA) regulations regarding the protection of patient health information. This includes adherence to the organization's Notice of Privacy Practices and HIPAA Privacy Policies and Procedures.

The specific statements provided in this job description are not exhaustive and may be subject to change based on evolving business needs. Associates may be required to perform additional duties as assigned.

Here at Prompt, we are committed to fostering a fair and respectful work environment. As part of this commitment, it is our policy not to hire individuals from Prompt Customers unless they have obtained their current employer's explicit consent. We believe in upholding strong professional relationships and respecting the agreements and commitments our customers have with their employees.We appreciate your understanding and cooperation regarding this policy. Please don't hesitate to inquire with our team.

Prompt Therapy Solutions, Inc is an equal opportunity employer, indiscriminate of race, color, religion, ethnicity, ancestry, national origin, sex, gender, gender identity, sexual orientation, age, marital status, veteran status, disability, medical condition, or any other protected characteristic. We celebrate diversity and are committed to creating an inclusive environment for all employees.