Accounts Receivable Specialist

Summary

Action Behavior Centers provides applied behavior analysis therapy and supports children with autism through a growing network of care centers. The Accounts Receivable Specialist I supports the company’s financial health by following up on medical claims, resolving payer issues and denials, collecting outstanding receivables, and collaborating with revenue cycle management teams.

Responsibilities

• Contact insurance carriers daily to follow up on past due amounts on outstanding medical claims by calling carriers, utilizing payer web portals, and working in tandem with your team
• Have a working knowledge of In and Out of Network reimbursement processes/methodologies
• Investigate and resolve claims that have been submitted to insurance for payment and create detailed follow-up notes that provide summary of actions taken and collection status
• Investigate and collect information related to claims denials and determine when it’s appropriate to file reconsiderations and/or appeals needed to contest incorrect insurance determinations
• Collaborate daily with other departments within RCM to resolve claims processing issues and work to ensure timely processing and reimbursement of assigned insurance carriers
• Work with AR Management to identify and resolve outstanding payer issues and trends as they arise and be able to effectively handle insurance claims specialists with a strategic and systematic approach
• Provide high quality customer service to our clients, including but not limited to, calling clients to discuss their insurance coverage, coordination of benefits, lapses in coverage and more
• Comply with and maintain integrity of confidential information, security policies, procedures, and PHI

Skills

• The ideal candidate will have a minimum of 3+ years of experience working in various medical specialties, with a background in third party billing/revenue cycle management
• High School Diploma required
• In-depth knowledge of medical and insurance terminology and guidelines
• 2+ years of experience managing medical receivables with a track record of success
• Strong analytical and mathematical skills with the ability to identify trends and opportunities for process improvement
• Ability to communicate clearly and effectively, both written and orally
• Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community
• Experience using Excel; from basic formulas up to compiling ad-hoc reports for global claims projects
• Ability to work within multiple systems to locate information needed to support claims research and resolution
• Bachelor's degree in business/management or related area (or equivalent experience in revenue cycle management) preferred
• Experience working in CentralReach practice management system preferred
• Experience working in Applied Behavioral Analysis preferred
• Experience working both in and out of network environments is a plus

Qualifications

Must Haves

• The ideal candidate will have a minimum of 3+ years of experience working in various medical specialties, with a background in third party billing/revenue cycle management
• High School Diploma required
• In-depth knowledge of medical and insurance terminology and guidelines
• 2+ years of experience managing medical receivables with a track record of success
• Strong analytical and mathematical skills with the ability to identify trends and opportunities for process improvement
• Ability to communicate clearly and effectively, both written and orally
• Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community
• Experience using Excel; from basic formulas up to compiling ad-hoc reports for global claims projects
• Ability to work within multiple systems to locate information needed to support claims research and resolution

Nice to Haves

• bachelor's degree in business/management or related area (or equivalent experience in revenue cycle management) preferred
• Experience working in CentralReach practice management system preferred
• Experience working in Applied Behavioral Analysis preferred
• Experience working both in and out of network environments is a plus

Benefits

• 10 Days of PTO, 10 Paid Holidays, 2 Flex Days + More with Tenure
• Student Loan Repayment Employer Contributions
• Maternity/Paternity Award of up to $3,000 & FSA Options for Childcare
• Door Dash Pass, Team Happy Hours, and Regional Night of Honors
• Up to $600 Student Loan Repayment Options & Tuition Discounts.
• Quarterly Team outings and events to bond and celebrate our wins both big and small!
• Professional development: we want to pour into you as you pour into ABC
• Leadership opportunities: To be the best, we have to continually keep learning and you get to push yourself here to learn more and take on more responsibilities, and show what you can do!
• 401K Retirement Plans with company matching
• Remote if outside of the Austin area