Accounts Receivable Specialist

Job Type

Full-time

Description

Responsibilities and Duties:

An Accounts Receivable Specialist manages claim denials associated with referrals, authorizations, notifications, non-coverage, and medical necessity. An Accounts Receivable Specialist reviews claim denials and notes, and the patient’s medical record, to determine whether resubmission, retro-authorization, appeal, or no action is needed.

• Maintains working reimbursement knowledge of equipment provided by the organization
• Researches payer denials and billing which resulted in denial and payment delay
• Submits appeals to payers based on review of medical records and in accordance with payer requirements
• Performs resubmissions. Submits retro-authorizations and appeals.
• Identifies denial patterns and assists management with root cause analysis, education, and/or recommendations for workflow changes to improve business practices
• Assists patients over the phone and in-person
• Attends in-services and meetings

About Us ---

Great Elm Healthcare, is a full service DME and complex mobility medical provider focused on continued excellence in patient care. Our family of companies have grown over the last several years and so has our commitment to provide the best possible service one patient at a time.

Our Values: A Great Elm Healthcare team member is...

• Collaborative and works with others to find solutions
• Results-driven and identifies and achieves goals that further our Mission
• Innovative and seeks solutions to challenges and takes initiative to improve
• Sincere and works with honesty, integrity and empathy
• Professional with high expectations for quality of work, competence, demeanor, ethics

Our Mission: Enhance patient outcomes by providing exceptional service and compassionate care

Benefits:

• Paid Time Off
• On-the-job training

Requirements

About You ---

• High school diploma or equivalent
• Minimum two years related experience
• Experience with Medicare and third-party reimbursement preferred
• Previous large practice or DME experience preferred
• Strong verbal and written communication skills; Strong organizational skills and attention to detail; Strong analytical, problem-solving, and time management skills
• Proficient with Microsoft Office, including Word, Teams, and Outlook; particular proficiency with Excel workbooks