Receivable Specialist R35034

Baystate Health; Greater London; Hybrid; GBP 80,000 - 100,000

Job description

Req#: R35034
Category(s): Finance, Accounts Receivable
Full Time / Part Time: Full-Time
Shift: First

Summary:

Schedule: Monday-Friday 8a-430pm; 1st Shift

Location: Hybrid opportunity after training completed

Under the direction of the Accounts Receivables Manager, Supervisor and Team Lead, identifies denials/appeals, makes appropriate system changes, completes balance adjustments, initiates write-offs, updates account registration/insurance information, documents work-in-process, obtains materials to complete the collection and/or appeals process, and mentors colleagues. Other related duties as required.

Job Responsibilities:

1. Reviews all accounts/invoices for collection/appeal activities and takes appropriate action based on findings. Prioritizes worklists in Athena IDX Enterprise Task Management (ETM) program.
2. Reviews all denied claims for third party payer on "Explanation of Benefits" and remittance advises and takes appropriate action based on findings.
3. Appeals claims from third party carriers with additional documentation as needed for appropriate reimbursement.
4. Initiates insurance reimbursement inquiries to appropriate compliance analyst for additional appeal opportunities, denial prevention, updates to our internal claim editing system, etc.
5. Initiates charge corrections as needed, based on eligibility updates, Coding Department instructions or Reimbursement Inquiry resolutions.
6. Accurately records and files all third-party payer information, reimbursement inquiries and appeals in process.
7. Interacts effectively with external contacts and keeps management team abreast of all assigned payer issues and volume changes that affect Key Performance Indicators (KPI) for the department.
8. Accurately document all action taken to collect on outstanding AR, for further follow up.
9. Completes assigned projects with advanced productivity and efficiency while maintaining a high degree of accuracy.
10. Shares current appeal/collection procedures with teammates and assists with training as needed.
11. Performs other duties as assigned, which include supporting other BMP billing departments.

Required Work Experience:

1. Knowledge of current third-party medical billing and collection regulatory guidelines and requirements.
2. Two or more years third party billing experience.

Preferred Work Experience:

1. Knowledge of Athena IDX.

Skills and Competencies:

1. Candidate must be able to work in a fast-paced environment and be able to multitask, while handling different assignments.

Education:

GED or HiSET (Required)

Certifications:

Equal Employment Opportunity Employer

Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.

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