
Medically Oriented Revenue Recovery Expert
2 days ago
The role of a Medical Accounts Receivable Specialist is pivotal in the financial operations of an organization. This professional plays a crucial part in managing and monitoring incoming payments, ensuring accuracy in accounts receivable records.
This position requires a detail-oriented individual with strong analytical skills and a solid understanding of accounting principles. The specialist will work closely with internal teams and external clients to resolve any billing discrepancies and facilitate timely payments.
Responsibilities:- Manage accounts receivable using Epic Resoluteto follow up on claims, manage denials, and process collections.
- Monitor aging reports and work queues (WQs)to ensure timely and accurate resolution of outstanding balances.
- Investigate and resolve claim denials and underpayments, identifying root causes and trends for corrective action.
- Process insurance follow-upsthrough Epic workflows, ensuring appropriate documentation and follow-through.
- Coordinate rebilling or appealswith payers directly through Epic or payer portals as needed.
- Document all AR activitiesaccurately and consistently in Epic, following departmental standards and compliance guidelines.
- Work on payer-specific work queuesto meet productivity and performance benchmarks.
- Utilize Epic's reporting tools and dashboardsto track performance metrics, identify bottlenecks, and support process improvement initiatives.
- Maintain compliance with payer guidelines, HIPAA regulations, and internal billing policiesthroughout AR processes.
- Collaborate with coding, billing, and patient access teamsto resolve account discrepancies and ensure clean claim submission.
- Escalate unresolved issues appropriately, providing context and documentation through Epic.
- Participate in regular audits and account reviews, helping to improve collection rates and reduce days in AR (DAR).
- Stay updated with Epic system updates and payer policy changes, applying changes as needed to AR workflows.
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