Accounts Receivable Specialist
Any individual who receives an offer of employment or will receive a payroll check are required to submit to a drug and alcohol test as a condition of obtaining employment.
Mille Lacs Band Member/American Indian preference applies
The Accounts Receivable Specialist is to perform the accounts receivable support function through the posting of payments, adjustments and denials to the account receivable section within billing system and to maintain balance of all deposits and accounts.
• High School Diploma or GED required.
• One to three years prior experience with third party billing receivables in a medical clinic setting.
• Thorough understanding of computer systems, knowledge of Windows and MS Office, RPMS billing software and other billing packages.
• Knowledge and understanding of established and standardized business office procedures and clinic policies sufficient to handle duties.
• Working knowledge of ICD-10 and CPT/HCPC’s coding terms in order to interpret and resolve problems based on information.
• General knowledge of third party payer reimbursement logic and accounts receivable management.
• Knowledge of a variety of accounting transactions and documents, codes, structures and procedures.
• Exceptional organizational skills.
• Experience with database management.
• Knowledge of patient care charts and patient histories.
• Ability to gather data, compile information and prepare reports.
• Knowledge of HIPAA regulations and the Data Privacy Act of 1974 and the ability to maintain strict confidentiality of patient, medical, clinic and Band information
• Knowledge of and sensitivity to Native American Culture.
• Must have a current valid driver’s license.
• Must be insurable under the Mille Lacs Band Drivers Insurance policy.
• Must pass a background check.
• Must pass a Pre-employment drug & alcohol test.
DUTIES AND RESPONSIBILITIES:
• Maintains accounts by reviewing documents to verify data to be entered in the system. Reconcile accounts comparing balances with related data to assure balancing, review records and source documents to identify sources of discrepancies and determining entries needed to bring accounts into balance.
• Performs work consisting of examination for accuracy of claims and other requests for payments for services by the government, insurance companies and beneficiaries
• Maintain accounts receivable ledger associated with third party payer claims. Review and reconcile all third party payer documents for correct data, on all third party vouchers for accurate claims number
• Prepares monthly, quarterly and annual reconciliation and recapitulation of third party billing to assure that collections, billed data and the computerized and manual reports balance
• Reviews and examines various types of bills, from patient and client care to third party payers and performs third party collection posting to the automated receivable program.
• Receives and reviews all explanation of benefits and remittance from third party payers. Identifies and records proper claim numbers on each remittance and post to the appropriate account
• Responsible for the posting of all contractual/adjustments related to and in conjunction with posting of payments and investigating denials in accordance with HHS policy
• Audit all documents received for completeness and accuracy, analyze and select guide to determine whether payments are full or partial in accordance with HHS policy and procedure; whether they are timely
• Maintains current documentation and guidelines pertaining to reimbursement activities in appropriate files, binders, etc. and ensures preparation and distribution of copies to all appropriate disciplines
• Documents all activity performed on patient accounts in the billing system
• Responsible for self-education by reading all third party newsletters, periodicals and updates circulate by management. Attend all continuing education opportunities mad available
• Maintain a working knowledge of all applicable Federal, State and Band laws and regulation, as well as all policy and procedures
• Assure HIPAA compliance with regard to billing practices
• Actively participates in department meetings, committees and conferences
• Other duties as assigned
• Nature of work is such that incumbent experiences infrequent periods of moderate stress levels while dealing with patients, clients and payers. Workload may also be a significantly source of stress
• Work is exclusively indoors in a controlled climate area
• Little risk of danger or injury in the job
• Hours are typically 8-5, but possibly some extra hours