Job Purpose:
This position is responsible for Post-payment and Account Follow-up and/or grievance preparation of assigned Client Hospital Accounts Receivable. Responsibilities may include account maintenance of specialized or multiple payers including state and federal government programs, managed care, commercial and other insurance groups. The AR Specialist Lead will serve as a liaison to clinical auditors, other team members, hospital staff, government agencies and health plans to facilitate the appropriate and prompt payment of claims. The AR Specialist Lead will have a dual role supporting Savista while being a resource and escalation point for junior staff. It is expected that that AR lead will have the highest working knowledge of US Accounts receivable practices.
Essential Duties & Responsibilities:
- Performs all duties of AR Specialist I and II
– In addition:
- Utilizes reports for analysis and to monitor follow up activities and prioritization
- Assists organization with working through special projects as needed
- SME for colleagues and provide direction for resolution of accounts
- Assists in new hire training
- Assists in content building of training materials
- Works escalated accounts
- Proactively implements improvements and programming
Minimum Requirements & Competencies:
- 7+ years of medical collections/billing experience
- At least 6 months direct experience working in Epic’s billing modules (Epic Resolute PB or Epic Resolute HB)
- Intermediate knowledge of ICD-10, CPT, HCPCS and NCCI
- Expert knowledge of third party billing guidelines
- Expert knowledge of billing claim forms (UB04/1500)
- Expert knowledge of payor contracts
- Working Knowledge of Microsoft Word and Excel
- Intermediate working knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.)
- 3 Years working in Epic Medical Record system as a lead in billing, collecting, and follow-up
- Prior Supervisory or leadership experience
- Working knowledge of DDE Medicare claim system
- Knowledge of US government rules and regulations
- Must be willing to work onsite in Ortigas, Pasig City