Accounts Receivable Specialist - NextGen EHR
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 NextGen 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.
- Verify payments for private pay and insurance only clients are posted.
- Acquire documents needed to be in compliance with insurance companies and AHCCCS and DDD, such as prescriptions, authorizations and insurance information.
- 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.
- 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.
- Ability to read and understand an EOB
- Recent Training/Use of NextGen EHR
- 2 Years Minimum experience working in Accounts Receivable within a Healthcare organization.
- Able to work independently with little supervision
- Confidentiality - HIPPA compliance
- Associate degree or related work experience in related field (Minimum 2 years related work experience)
- Recent Training/Use of NextGen
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.