Accounts Receivable Specialist

2 weeks ago

Coimbatore, India Ventra Health Full time

Overview

  • The Accounts Receivable ("AR") Specialists are primarily responsible for analyzing collections, resolving non-payables, and handling bill inquiries for more complex issues. AR Specialists are responsible for insurance payer follow-up ensuring claims are paid according to client contracts. Complies with all applicable laws regarding billing standards.

Responsibilities

  • Follows up on claim rejections and denials to ensure appropriate reimbursement for our clients.
  • Process assigned AR work lists provided by the manager in a timely manner.
  • Write appeals using established guidelines to resolve claim denials with a goal of one contact resolution.
  • Identified and resolved denied, non-paid, and/or non-adjudicated claims and billing issues due to coverage issues, medical record requests, and authorizations.
  • Recommend accounts to be written off on Adjustment Request.
  • Reports address and/or filing rule changes to the manager.
  • Check the system for missing payments.
  • Properly notates patient accounts.
  • Review each piece of correspondence to determine specific problems.
  • Research patient accounts.
  • Reviews accounts and determines appropriate follow-up actions (adjustments, letters, phone insurance, etc.).
  • Processes and follows up on appeals. Files appeals on claim denials.
  • Inbound/outbound calls may be required for follow-up on accounts.
  • Respond to insurance company claim inquiries.
  • Communicates with insurance companies about the status of outstanding claims.
  • Meet established production and quality standards as set by Ventra Health.
  • Performs special projects and other duties as assigned.

Qualifications

  • High School Diploma or GED.
  • At least one (1) year in the data entry field and one (1) year in medical billing and claims resolution preferred.
  • AAHAM and/or HFMA certification preferred.
  • Experience with offshore engagement and collaboration desired.

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