N00301 – Accounts Receivable Specialist

Position Overview: The Accounts Receivable Specialist is responsible for extensive reviewing of explanations of benefits, denials, and open accounts receivable. Under minimal supervision and according to established procedures, policies, and detailed instructions, provide exceptional support and service to the internal and external customers of GENETWORx. This position interacts daily with team members and other departments in an effort to quickly resolve outstanding account balances while enhancing the customer experience and promoting corporate integrity and compliance.

Specific Responsibilities:

• Prioritizes daily work and accesses volumes to adjust workload and areas of focus as needed.
• Demonstrates world class customer service in accordance with the laboratory revenue cycle department service excellence standards when responding to patient or client verbal and written correspondence.
• Documents all responses and actions taken to reach claim or account resolution in the billing revenue cycle management system.
• Exhibits strong communication skills and positive attitude with internal (team members, other departments, and leadership) and external customers (patients, clients, insurance companies, vendors, and employers). Defuses volatile situations in a calm, objective, and tactful manner. Directs customer complaints to management for immediate response if unable to resolve.
• Maintains thorough knowledge of third-party eligibility and claim inquiry tools and applications, requirements, and regulatory guidelines.
• Audits all inquiries to confirm appropriateness of patient responsibility to ensure correct registration, coding, payment/adjustment posting, and insurance processing of claims.
• Meets all daily, monthly, and year end closing deadlines as they relate to the accounts receivable process.
• Meets or exceeds departmental productivity standards on a consistent basis.
• Identifies complex patient financial needs and informs patient of alternative forms of payment including self-pay options, or state and federal government sponsored care.
• Provides management, guidance, and training to staff in account research.
• Alerts the Billing Supervisor of Lab Revenue Cycle regarding any anomalies with the integrity of accounts receivable.
• Audits all explanations of benefits to confirm appropriateness of patient responsibility to ensure correct registration, coding, payment/adjustment posting, and insurance processing of claims.
• Processes remittance, payment, and other documentation including scanning and submission of information according to GENETWORx policy and procedure.
• Processes returned mail and updates patient demographic information in the billing accounts receivable management system.
• Informs the leader of consistent issues as they occur and make recommendations to improve departmental quality outcomes.
• Assists management in the development and implementation of new policies and procedures.
• Assists with maintaining net receivables based upon contractual requirements.
• Coordinates activity with internal and external customers and serves as primary contact person for issues relating to accounts receivable.
• Selects priorities and organizes work and time to meet them in order of importance.
• Performs office related support tasks, clerical duties and/or general office duties which may include creating reports, typing, filing, faxing, answering telephones, taking messages, and making copies.
• Participates as a team member by performing additional assignments not directly related to the job description when workload requires and as directed by management.
• Projects/Maintains a positive attitude and conducts his/herself in a manner conducive to improving the working environment and morale and supporting leadership initiatives.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines and regulations.
• Demonstrates attention to detail, initiative, and judgment.
• Exhibits poise, tact, and compassion dealing with patients and clients.
• Performs other duties and special projects as assigned.

Education and Experience:

• High school diploma or equivalent GED.
• A comprehensive understanding of insurance requirements and regulations, contract benefits, credit and collection procedures, financial assistance programs as well as a familiarity of medical terminology is required. This level of experience would generally be acquired through two to four years’ experience in medical billing.
• Work requires interpersonal skills necessary for making patient and third-party payer contacts. Must be able to work with interruption by co-workers or other internal customers needing assistance with patient accounts.
• Work requires advanced reading, writing and oral communication skills as well as the knowledge to perform mathematical calculations.
• The job requires analytical and critical thinking ability to diagnose account issues and active listening skills to provide service excellence. In addition, the work requires demonstrated project and time management skills and an ability to work effectively over the phone and in a team environment.
• Knowledge[CM1] of insurance including Medicare, Medicaid, HMO, PPO, Commercial insurance verification, in addition to, COB guidelines with familiarity of ICD-10 coding.
• Proficiency in Microsoft office suite, especially excel[CM2] .

Competencies:

Customer Service: Demonstrates concern for meeting internal and external customers’ needs in a manner that provides satisfaction for the customer within the resources that can be made available.

Integrity: Upholds personal and professional ethics and values, considering the values of GENETWORx and respecting the culture, beliefs, and abilities of individuals.

Ability to effectively perform in a fast-paced environment: Demonstrates the ability to respond to multiple difficult requests with a consistently high level of accuracy.

Work Environment: May work in a variety of environments including professional offices, clinics, hospitals, or out-patient facilities.

Physical Demands: While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands to finger, handle or feel objects, tools or controls. The employee is occasionally required to stand; walk; sit; reach with hands and arms; climb or balance; and stoop, kneel, crouch or crawl. The employee must occasionally lift and/or move objects up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, color vision, peripheral vision, and the ability to adjust focus.

Travel: Travel is primarily local during the business day, although some out-of-the-area and overnight travel may be expected