AR Account Follow-Up Specialist - Alabama Oncology

This position is located at the Birmingham Business Office

Summary: Under general supervision, an AR Account Follow-Up Specialist is responsible for account follow-up for all assigned accounts, resolving billing problems and answering patient inquiries. Uses collection techniques to keep accounts receivable current including monitoring for delinquent payments. The Account Follow-Up Specialist will review insurance claims and take the appropriate action, including completion of submissions, reconsiderations, appeals, or re-working denials, to ensure payment is received timely.

Essential Duties and Responsibilities:

• Performs audits of patient accounts to ensure accuracy and timely payment.
• Reviews account aging monthly and reports inconsistencies and correct errors as appropriate.
• Follows up on insurance billing to ensure timely receipt of payments.
• Demonstrates the ability to deal with patients and insurance companies regarding sensitive financial matters and recapture unpaid balances.
• Receives and resolves patient billing complaints and questions; initiates adjustments as necessary; follows up on all zero payment explanations of benefits and exercises all options to obtain claim payments.
• Reviews credit balance reports for correct recipient of refund.
• Performs reconciliation of refund accounts; attaches documentation and forwards to supervisor to process refund checks.
• Identifies problems on accounts and follows through to conclusion.
• Responds to insurance companies requests for information in a prompt and professional manner.
• Reviews appropriate files to identify deceased patients and estates; verifies dollar amounts and files estate to appropriate court in a timely manner.
• Reviews EOBs to ensure proper reimbursement of claims and reports any problems, issues, or payor trends to supervisor.
• Resubmits insurance claims within 72 hours of receipt.
• Participates in maintaining Payor Manuals/Profiles.
• Works closely with collection agency to assure that they receive updated information on accounts as necessary.
• Prepares write-off requests with appropriate documentation and submits to supervisor.
• Processes insurance/patient correspondence, including denial follow-up within 48 hours of receipt. Files all reimbursement correspondence daily.
• Works with provided aging to monitor patient account aging and follows up appropriately.
• Maintains confidentiality in regard to patient account status and the financial affairs of clinic/corporation.
• Other relevant duties as assigned

• Must possess a comprehensive knowledge of revenue cycle functions and systems, physician practice revenue cycle operations, revenue metrics and analytics.
  
• Must have strong management and leadership skills that emphasize team building and collaboration. Not afraid to jump in and help with backlogs or projects.
  
• Excellent communications skills, written and verbal with ability to provide clear direction to staff as well as presentation skills.
  
• Proficient with computers and their applications including EMR’s, Practice Management systems, databases, and Microsoft Office products such as Outlook, Excel, and Word.
  
• Have a track record of leadership success in healthcare revenue cycle management.
  
• Demonstrated knowledge of the federal, state, and local regulatory requirements around medical billing and coding as well as CMS and payer regulations.
  
• Ability to work independently.
  
• Able to manage multiple projects at once, ability to work efficiently and effectively under tight deadlines.
  
• Demonstrates advanced analytical, evaluative, problem solving and decision-making, fostering innovative approaches to situations/processes/issues.
  
• Strong collaborative leadership qualities, willing to work side by side with staff when “hands on” approach is needed.
• Experience in a complex healthcare organization preferred with oncology experience highly desirable.

Requirements

• Bachelors (preferred) in healthcare, accounting or related field or a high school graduate
• 3 plus years of experience
• Experience in medical billing /insurance processing and balancing accounts