Medical Accounts Receivable Specialist in Gainesville, FL at NurseCore

Date Posted: 3/8/2020

Job Snapshot

Job Description

Overview

Medical Accounts Receivable Specialist

NurseCore has an exciting opportunity for you! We are seeking an Accounts Receivable Specialist for our Gainesville, FL location.  If you’re motivated, enthusiastic, flexible, and have experience in medical collections, we want you on our team! Join us at the heart of healthcare, apply today! 

Responsibilities

The Accounts Receivable Specialist is responsible for managing AR for timely collections. Accounts Receivable Specialists must be skilled at record-keeping and interacting with clients and customers in an effective and professional manner. 

  • Monitor the timely filing of claims
  • Work Branch Office Aging Report (ALL AR)
  • Status Claims via Portal, Phone, or Denial Correspondence
  • Provide expertise on Explanation of Benefits (EOBs)
  • Follow-up on open and pending insurance claims to ensure collection within insurance company time limits.
  • Denial Management by investigating the reasons for denials, finding denial management strategies and when necessary appealing denials
  • Identifies billing errors, short payments, over payments, unpaid claims, and resolves accordingly - Reviews residual balances after payments are applied and generates necessary adjustments, overpayment notification, refund requests, and/or secondary billing as needed.
  • Develop payor processes to reduce the denials of claims
  • Prepare and Submit Insurance Claim Appeals to payors
  • Contact Clients on Private Pay Accounts
  • Supports and exemplifies AWESome company initiatives
  • All other duties as assigned
Qualifications

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.

  • Excellent working knowledge of primary and secondary insurance claims
  • Experience handling a wide variety of payers from multiple states and markets
  • Ability to work independently, and work in a challenging environment
  • Excellent computer skills (Word, Excel, Outlook); and experience with Insurance Portals
  • Denial management and persistent claims follow up skills ß A MUST
  • Ability to meet daily productivity goals and other tasks and metrics as assigned
  • Strong ability to identify, analyze and solve problems.
  • Self-motivated and approach tasks with a positive, proactive demeanor.
  • Work effectively in a team environment
  • Strong ability to identify, analyze and solve problems
  • Excellent interpersonal, verbal and written communication skills. Demonstrate the ability to communicate with and work well with all levels within an organization.

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