Accounts Receivable Specialist - Behavioral Health
The Accounts Receivable Specialist supports the S.E.E.K. Arizona team with daily duties and projects. This position is responsible for submitting claims and follow-up with insurance companies and contract claims. This position processes and monitors incoming payments and secures revenue by accurately verifying and posting payments in a timely manner. This position reports directly to the Outpatient Clinic Manager at S.E.E.K. Arizona.
- Responsible for all facets of medical billing including data entry, payment posting, claims appeals, customer service and follow-up in accordance with practice protocol and compliance with Medicaid and Third Party payers.
- Process any appeals and corrected claims necessary for HCBS and therapy for DDD as well as any and all claims for all other Medicaid and Third Party payers.
- Verifies client’s insurance eligibility and obtain any authorizations that are needed prior to services.
- Export claims for insurance only (except for MMIC and CRS) and enter into the appropriate billing software.
- Contact families and verify and explain benefits for clients that do not have a payer of last resort such as Medicaid.
- Work with the Therapy Liaison to ensure that payments are processed and collected for co-pays, deductibles and fees for insurance only and private pay clients.
- Verify payments for private pay and insurance only clients are posted in vTrack.
- Acquire documents needed to be in compliance with insurance companies and AHCCCS and DDD, such as prescriptions, authorizations and insurance information.
- Receive and enter billing from therapists and other providers, ensuring correct and accurate information through the process using a variety of billing software.
- Data entry of behavioral health billing ensuring correct and accurate information through the process using a variety of billing software.
- Post all payments received into the appropriate billing software including co-payments, insurance payments and patient payments in accordance with practice protocol and with accuracy.
- Make appropriate adjustments in accordance with practice protocol.
- Follow-up on all outstanding insurance claims at 60 days from date of service to ensure claims adjudication.
- Follow-up on all returned claims, correspondence, denials, account reconciliations and remits on a weekly basis.
- Process refunds to insurance companies, contracts and/or clients as needed.
- Review payments and reimbursements from contracts and insurance companies to ensure rates are accurate.
- Prepare and review statements for insurance and member aging, dates of service, practice analysis, unapplied payments/adjustments reports, deposits and production reports on a semi-monthly basis.
- Keep team apprised of matters regarding billing charge entries and charge status, making appropriate changes for corrected billing resubmittals.
- Keeps documentation and notes in clients’ accounts in the various billing software.
- Maintain an organized, efficient and professional work environment.
- Perform other duties as assigned
Knowledge, Skills & Abilities:
- Knowledge of medical coding, billing and collection practices.
- Knowledge of third party operating procedures and practices
- Requires knowledge of Medicaid and Third Party insurance payors.
- Hands-on experience in operating spreadsheets and accounting software
- Discretion with sensitive information.
- Ability to read and understand an EOB
- Working knowledge of database, MS Word, MS Excel, Outlook
- Office Equipment - fax machines, copiers, scanners, phones, etc.
- Accurate keyboard and data entry
- Customer Service skills
- Excellent telephone & interpersonal skills
- Ability to multi-task
- Organized, attention to detail
- Friendly, courteous & professional
- Able to work independently with little supervision
- Confidentiality - HIPPA compliance
- Can work effectively in both quiet and noisy environments
- Associate degree or related work experience in related field
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function. Lifting up to 30 pounds may be necessary.