Accounts Receivable Specialist

Position Summary:  Ensures that all claims are paid in a timely fashion. If claim is not paid within 60 days from date billed, claim is looked into for rejection and resolution of issue within the timely filing period and the 60-day turnaround of payment. 95% of our facility claims are billed electronically which allows us to receive payment much quicker; usually within 2-3 weeks. Bills third party payers and/or patients for facility associated with procedures performed in the surgiclinic. Appeals to insurance if needed on problem claims. Patient balances. Uploads patient statement files weekly. Patient balances that are over 90 days are referred to me if no cooperation of payment from patient for turnover to collection agency.

Duties and Responsibilities:

Must be able to interpret and understand operative reports, physician’s notes, the operative report, or lab reports, to determine assignment of the appropriate CPT procedure code(s) for each patient visit if the claim denies and any modifiers if necessary, based on payer and CPT. Refers to the current AMA CPT Code Book, ICD-10 Diagnosis Book, and procedure lists provided by the payer for coding.  Any questions of proper coding are referred to the Billing Manager.  

Prepares and posts insurance deposits after obtaining online EOB from Electronic Deposits. Balance bills patient for copays, coinsurance and deductibles.  

Responsible for collecting payment 1 week before date of surgery for cosmetic surgery and for patients who do not have insurance. Answers telephone and resolves patient questions/issues. Obtains patient payments via telephone and processes.  

Daily lunches for the physicians and staff are called in timely by 10:30 AM. Assists in collecting money for employee lunches.

Closes each month’s billing cycle once all deposits are posted and balanced. Assists when asked to perform monthly closing. Communicates with the Business Office Manager regarding any issues or questions that may arise.

Protects the patient’s/facility’s right of privacy and confidentiality.

Relates to patients, physicians and their office staff in a pleasant and effective manner. 

Participates in maintaining a pleasant work environment with co-workers and supports the mission and goals of the Same Day SurgiCare. 

Job Specifications: 

Educational Requirements:  High school diploma and attendance of a medical/business education program related to billing/coding. Familiarity with anatomy and physiology and medical terminology. Requires good communication skills, both verbal and written, the physical ability to type with speed and accuracy, communicate on the phone, and lift and reach to retrieve or file.