Insurance AR Specialist

The Accounts Receivable is responsible for handling all correspondence related to an insurance or patient account, contacting insurance carriers, patients, and other facilities as needed to get maximum payment on accounts and identify issues or changes to achieve client profitability, and includes the ability to interpret and rectify denials.

Condition of Employment:

· Must successfully pass the initial and updated criminal history, background, and record checks, which includes driving history checks.

· Must wear appropriate Personal Protective Equipment (PPE), as provided by LittleStar, where physical distance cannot be attained.

Essential Duties and Responsibilities:

· Ability to research and resolve accounts assigned by management, making appropriate decisions on accounts to be worked to maximize reimbursement.

· Research and re-bill unpaid claims

· Prepare paperwork to submit to insurance for client pre-certification of services.

· Research and resolve accounts appearing on Follow-up Reports

· Make appropriate decisions and calls to carriers to maximize reimbursement on accounts to be worked.

· Correct all errors on electronic error reports using all available information.

· Participates in trainings/meetings with Payers, internal departments, other ABA owners, and Client contact(s)

· To address trends in denials or unprocessed claims

· Assists in identifying current and/or potential billing issues specific to outstanding receivable.

· Presenting data to appropriate parties and partnering to develop resolutions.

· Participates in daily production assignments that will continue to develop understanding and knowledge of processing guidelines and expectations of respective client(s) payer mix.

· Maintain insurance and client files.

· Provide support to clients regarding insurance issues.

· Maintain confidentiality of center fiscal information.

· Maintaining Client files.

· Maintain client confidentiality per LS policy and HIPAA Privacy Rule Regulations.

· Act as a positive role model for all staff, families and children working with LS and model a high standard of reliability, accuracy, integrity, and professionalism.

· Work to positively impact team spirit and overall morale.

· Adhere to all LS policies and procedures.

· Perform other duties as assigned by supervisors.

· Communicate issues, info and support needs to Insurance Director, VP of Insurance and Billing Manager.

· Prepare various reports as needed for Insurance Director, CFO, VP of Insurance and Compliance Officer, and/or Chief Executive Officer.

Educational Qualifications and Skills:

· High School diploma or GED required.

· 1-2 years’ experience with insurance in a medical office setting strongly preferred.

· Medical billing experience preferred.

· Experience with Practice Management software.

· Technology competent, including Microsoft Office, Accounts Payable, Quick Books, email, and Internet.

· A positive team player and energetic professional.

· Strong organizational habits with attention to detail and accuracy.

· Good time management skills along with the ability to manage multiple tasks.

· Ability to analyze/solve problems and work in a fast-paced environment.

· Strong communication skills with ability to communicate appropriately given the circumstances of the situation and audience involved.

· Discretion in matters that need to remain private.

· Ability to work with a variety of people, both internal and external.

Supervisory Responsibility

This position has no supervisory responsibilities.

Work Environment

Position operates in a professional office environment. This role routinely uses standard office and audiovisual equipment. Position is eligible to telecommute up to 60% of the time.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to stand; walk, climb stairs, use hands to finger, handle or feel; and reach with hands and arms. Must be able to lift up to 25 pounds.

Reasonable accommodations can be provided to assist or enable qualified individuals with disabilities to perform the essential functions of the position, upon request.
 

Travel

Travel is generally not required for this position but may occur occasionally to satellite centers, trainings or conferences as needed.