PMC Accounts Receivable Specialist
On-siteShawnee, Oklahoma, United States
Job Summary
Manage Accounts Receivable by submitting claims to Medicare, Medicaid, and various insurance carriers, reviewing problem claims with a manager, and re-submitting denials to ensure proper payment. Enter charges for services rendered, download Medicare receipts, and maintain logs for collections and QA. Follow up on collections via phone calls, research correspondence from carriers and patients, and correct claim edits. Monitor plan bulletins for submission updates and provide professional customer service to patients and the public. Ensure strict confidentiality of financial and medical records under HIPAA and hospital policies.
Required Qualifications
- Knowledgeable in Medicare, Medicaid, Worker's Compensation and Third Party Payer claim processing
- Knowledgeable in bookkeeping
- Computer skills as related to claims processing
- Organizational skills
- Ability to work independently
- Knowledge of Level I Healthcare Common Procedure Coding Systems (HCPCS) comprised of Current Procedural Terminology (CPT-4) and International Classification of Diseases (ICD) codes
- Demonstrates knowledge and ability to follow medical billing practices
- Knowledge of Medicare, Medicaid, Insurance Managed Care Plans and Workmen's Compensation
- Communicates in an effective manner
- Follow written or verbal instructions
- Demonstrates good interpersonal skills to deal with team members, patients and families
- Knowledge of insurance policies
- Competent with the accounts receivable accounting system
- Competent in Microsoft Office Word and Excel
- Maintain discretion and confidentiality in communications
- Familiar with policies and procedures regarding reporting and release of protected health information (PHI)
- High School Diploma/GED
- 1 year experience in bookkeeping, clerical and applicable computer training
- Must be proficient at mathematical and statistical calculations
- Communicate verbally and in writing in English
- Must be able to lift 25 pounds from the floor to waist level
- Specific vision abilities include close vision and the ability to clearly focus vision
Desired Qualifications
- Prior physician office or medical coding, preferred
- MediTech Experience, preferred
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