Summary
Alliance Health System provides operational and administrative support to healthcare organizations. The Accounts Receivable Specialist manages medical billing and collections by resolving denied or underpaid claims, following up with insurers and patients, and supporting compliant revenue cycle operations.
Responsibilities
- Denial Management: Investigate and resolve claim denials by appealing, resubmitting, or making necessary corrections
- Follow-Up: Conduct regular follow-ups with insurance companies and patients to ensure timely payment of outstanding balances
- Compliance: Stay updated on industry regulations and compliance requirements to ensure adherence in billing practices
Skills
- * Claim Resolution and Reimbursement: Demonstrate strong desire and commitment to resolving medical claims and effectively collecting insurance reimbursements
- * Organizational Skills: Must possess excellent organizational skills with thorough attention to detail in handling accounts receivable processes
- * Independence and Collaboration: Ability to work independently and collaboratively within a group, fostering a team-oriented and efficient work environment
- * Communication Skills: Exceptional written and verbal communication skills are essential, showcasing the ability to interact professionally and effectively with both internal and external stakeholders
- * Medical Billing/Collections Professional: Proven experience in resolving denied/underpaid claims and conducting thorough follow-ups with insurance providers to maximize reimbursements
- * Diverse Responsibilities: Extensive experience in various aspects of medical billing and collections, including but not limited to claim submissions, attorney follow-ups, and other duties relevant to the field
- * Excel/Google Sheets: Demonstrated proficiency in utilizing Excel and Google Sheets for data analysis and reporting purposes
- * Out of Network Experience: Proven track record of handling Out of Network billing processes effectively
- * Payer Portals: Familiarity with various Payer Portals for streamlined communication and efficient claims processing
- * Specialized Expertise: Prior experience in Conservative Therapy (Physical Therapy, Occupational Therapy, and Chiropractic), Medical (Physical Medicine and Rehabilitation, with expertise in Pain Management, Orthopedic, and Vascular disciplines), or Patient Accounts (Self Pay) is preferred
- * Insurance Knowledge: Extensive experience with all Major Medical Insurance Providers, Work Comp, and Motor Vehicle claims is preferred
- * Bilingual Skills: Fluency in Spanish is a plus
Qualifications
Must Haves
- * Claim Resolution and Reimbursement: Demonstrate strong desire and commitment to resolving medical claims and effectively collecting insurance reimbursements
- * Organizational Skills: Must possess excellent organizational skills with thorough attention to detail in handling accounts receivable processes
- * Independence and Collaboration: Ability to work independently and collaboratively within a group, fostering a team-oriented and efficient work environment
- * Communication Skills: Exceptional written and verbal communication skills are essential, showcasing the ability to interact professionally and effectively with both internal and external stakeholders
- * Medical Billing/Collections Professional: Proven experience in resolving denied/underpaid claims and conducting thorough follow-ups with insurance providers to maximize reimbursements
- * Diverse Responsibilities: Extensive experience in various aspects of medical billing and collections, including but not limited to claim submissions, attorney follow-ups, and other duties relevant to the field
- * Excel/Google Sheets: Demonstrated proficiency in utilizing Excel and Google Sheets for data analysis and reporting purposes
- * Out of Network Experience: Proven track record of handling Out of Network billing processes effectively
- * Payer Portals: Familiarity with various Payer Portals for streamlined communication and efficient claims processing
Nice to Haves
- * Specialized Expertise: Prior experience in Conservative Therapy (Physical Therapy, Occupational Therapy, and Chiropractic), Medical (Physical Medicine and Rehabilitation, with expertise in Pain Management, Orthopedic, and Vascular disciplines), or Patient Accounts (Self Pay) is preferred
- * Insurance Knowledge: Extensive experience with all Major Medical Insurance Providers, Work Comp, and Motor Vehicle claims is preferred
- * Bilingual Skills: Fluency in Spanish is a plus
Benefits
- 401(k) matching
- Medical, Dental & Vision
- Paid Time Off
- Sick Time
- Paid Holidays
- Fully remote