The Accounts Receivable Specialist is responsible for managing and optimizing the healthcare revenue cycle, within post-acute care settings amongst other settings. This individual will ensure timely, accurate billing and collection processes while maintaining compliance with healthcare regulations. The role requires a deep understanding of billing, insurance claims, Medicare/Medicaid regulations, and post-acute care operations.
Key Responsibilities:
Billing and Collections: Manage accounts receivable processes, including billing, follow-up, and collections for patient care services.
Claims Management: Submit accurate claims to third-party payers (Medicare, Medicaid, private insurance) and follow up on unpaid or denied claims.
Revenue Tracking: Reconcile accounts, process payments, and manage adjustments to ensure timely and accurate posting of payments.
Patient Account Management: Resolve patient inquiries regarding billing and account status, ensuring a high level of customer service.
Compliance: Ensure adherence to all applicable laws, regulations, and policies governing healthcare revenue cycle management, particularly in the post-acute care sector.
Reporting: Prepare and present financial reports on accounts receivable metrics, collection trends, and cash flow projections to management.
Coordination with Other Departments: Collaborate with the clinical and administrative teams to resolve billing discrepancies and optimize revenue cycle workflows.
Denial Management: Proactively address and resolve payer denials, underpayments, and other claims-related issues in a timely manner.
Qualifications:
Education: High school diploma or equivalent; Associate's degree in accounting, finance, or healthcare administration preferred.
Experience: Minimum of 2-3 years of experience in accounts receivable, billing, or revenue cycle management, ideally in the healthcare or post-acute care setting.
Knowledge: Familiarity with Medicare, Medicaid, and private insurance billing; understanding of healthcare regulations and the unique revenue cycle needs of post-acute care.
Technical Skills: Proficiency in healthcare billing software, electronic health record (EHR) systems, and Microsoft Office Suite (Excel, Word).
Communication Skills: Strong interpersonal and communication skills to collaborate with patients, payers, and internal teams.
Problem-Solving: Ability to analyze and resolve issues related to billing, claims processing, and accounts reconciliation.
Attention to Detail: High degree of accuracy in managing financial records and processing claims
Preferred Qualifications:
Experience working with all payors.
Previous experience in the post-acute or skilled nursing care sector preferred.