A/R follow

3 weeks ago

Angeles, Philippines Connext Full time

A/R follow-up Specialist with EPIC Healthcare Software | 25% Night Differential | Working Onsite

The A/R Follow-Up Specialist is responsible for billing, re-billing, post-payment, and account follow-up on assigned hospital accounts receivable. The role manages claim status checks, denials, appeals, and payer communication to ensure accurate reimbursement and timely resolution.

Responsibilities

  • Access and navigate payer websites and portals to verify eligibility, authorization, and claim status.
  • Update patient demographics and insurance information in appropriate systems.
  • Research and resolve unpaid or denied claims, including missing information, authorization, and control numbers (ICN/DCN).
  • Review EOBs for adjustments and process corrections to resolve claims.
  • Contact insurance payers via phone or written correspondence to secure payment of claims.
  • Research and respond to payer requests for additional documentation.
  • Verify accuracy of underpayments using contracts and claims data.
  • Write appeal letters for technical appeals and denial management.
  • Prepare claims for clinical audit processing (authorization, coding, level of care, length of stay denials).
  • Maintain confidentiality of patient information in accordance with HIPAA regulations and company policy.
  • Collaborate with billing teams, coders, and payment posters to ensure accurate claim processing.
  • Document all claim activity, follow-ups, and resolutions in the billing system.
  • Adhere to payer policies, guidelines, and submission requirements.
  • Perform other related duties as assigned by the AR Manager or Supervisor.

Qualifications and Requirements

  • Experience using Microsoft Word and Excel.
  • Familiar with ICD-10, CPT, HCPCS, and NCCI.
  • Familiar with billing claim forms (UB04/1500).
  • Hands-on experience with health information systems (EMR, Claim Scrubbers, Patient Accounting Systems, etc.).
  • Knowledge in third-party billing guidelines and payor contracts.
  • Demonstrates strong organizational and time management skills with the ability to prioritize tasks effectively.
  • Detail-oriented with high accuracy in claim documentation and processing.
  • Clear and coherent both written and verbal communication skills in English.

Screening Criteria

  • High school diploma or equivalent required.
  • Minimum of two (2) years of experience in medical collections or billing.
  • Minimum of two (2) years of experience using EPIC healthcare software.
  • Must have a stable employment history.
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