Accounts Receivable Specialist
The Account Receivable Specialist services as optical store assistant who helps process insurance claims for insurance companies, make sure claims from the insurance come back, make proper adjustments, and also keep account of unpaid invoices from patients. He/she must be willing to be familiar with insurance diagnosis codes, optical terminology and have a firm understanding of the optical field.
*Major Duties and Responsibilities*
- Assembles and maintains patient records
- Reviews patient records and interact with optometrists to ensure all relevant information has been recorded
- Gather and review medical documentation for qualifying coverage to ensure payment will be made
- Obtain, verify and maintain current insurance info to ensure proper and timely claim payment
- Review, correct and submit claims/invoices for payment Obtain Prior Authorizations as necessary by product line and payer Interpret denials/correspondence and work with insurance companies to receive payment.
- Submit reconsiderations, redeterminations and appeals when applicable
- Document want is claimed and what is reimbursed.
- Follow-up on aging accounts receivable from patients who jobs are complete.
- Utilize payer resources, web portals and customer service phone lines to communicate with payers regarding timely reimbursement and denials
- Able to work independently and in a team atmosphere.
- Proficient in Microsoft Office, Word and Excel.
- High level of accuracy and attention to detail a must.
- Demonstrate a high level of integrity and ability to problem solve.
- Must be comfortable navigating through a variety of software programs and insurance websites.
- Maintain thorough understanding of different insurance contracts/payers we handle and keep abreast of any changes with these contracts.
- Customer service driven with the ability to communicate effectively and maintain professional and ethical standards of conduct.
Prior experience in a fast paced medical billing environment is beneficial. Credentialing knowledge experience is a plus.
*Education and Experience*
- High school or equivalent.
- Accounting background and education a plus.