Avem Health Partners
Accounts Receivable Specialist
Avem Health Partners, Oklahoma City, Oklahoma, United States, 73116
Accounts Receivable Specialist
Job Purpose
Primarily responsible for effective collection on patient accounts, accounts receivable follow‑up, and reimbursement analysis for all non‑Government accounts.
Essential Functions
Manage assigned accounts ensuring outstanding/pending claims are paid at maximum reimbursement in a timely manner.
Request claims to be reprocessed where necessary or prepare and submit corrected claims to the insurance companies for payment.
Follow‑up on all outstanding insurance claims at 30‑days from the date of service with an emphasis on maximizing patient satisfaction and client profitability.
Review credit balance accounts for payer/patient refund requests and/or misapplied payments/adjustments.
Follow up on all returned claims, correspondence, denials, account reconciliations and rebills within two working days of receipt to achieve maximum reimbursement in a timely manner.
Communicate denial trends with Revenue Cycle Manager.
Apply knowledge of insurance guidelines, including HMO/PPO, Medicare, and Medicaid.
Obtain accurate and additional information from facilities as needed.
Comply with state and federal regulations, laws and company policies and procedures.
Help create, implement, and improve processes for the revenue cycle team.
Maintain strict confidentiality.
Support management on special projects.
Perform other duties as assigned.
Behavioral Standards
Support the mission, vision, and goals of Avem Health Partners and serve as a role model within the company.
Exhibit positive customer service behavior in everyday work interactions.
Demonstrate a courteous and respectful attitude to internal workforce and external customers.
Communicate accurately and appropriately.
Handle difficult situations discreetly and professionally.
Hold self‑accountable for professional practice.
Demonstrate knowledge of unit goals and be active in committees and projects to achieve these goals.
Keep current with literature regarding changing practices, interventions, and best practices in patient care.
Seek educational and professional opportunities for personal growth and meet mandatory education requirements.
Act as a preceptor when requested.
Demonstrate excellent work attendance and participate in meetings and training sessions as required.
Adhere to the Avem Health Partners Code of Conduct and Standards of Behavior, policies, procedures, and all health and safety requirements.
Education
High school diploma or equivalent.
At least two years of medical accounts receivable experience.
Certification / Licensure
Medical billing certification, if available.
Physical Requirements
Perform each essential job duty satisfactorily.
Knowledge, skill, and/or ability required, with reasonable accommodations available for disabilities.
Needs visual and auditory abilities to perform duties.
Seniority Level Entry level
Employment Type Full‑time
Job Function Accounting/Auditing and Finance
Industries Business Consulting and Services
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Essential Functions
Manage assigned accounts ensuring outstanding/pending claims are paid at maximum reimbursement in a timely manner.
Request claims to be reprocessed where necessary or prepare and submit corrected claims to the insurance companies for payment.
Follow‑up on all outstanding insurance claims at 30‑days from the date of service with an emphasis on maximizing patient satisfaction and client profitability.
Review credit balance accounts for payer/patient refund requests and/or misapplied payments/adjustments.
Follow up on all returned claims, correspondence, denials, account reconciliations and rebills within two working days of receipt to achieve maximum reimbursement in a timely manner.
Communicate denial trends with Revenue Cycle Manager.
Apply knowledge of insurance guidelines, including HMO/PPO, Medicare, and Medicaid.
Obtain accurate and additional information from facilities as needed.
Comply with state and federal regulations, laws and company policies and procedures.
Help create, implement, and improve processes for the revenue cycle team.
Maintain strict confidentiality.
Support management on special projects.
Perform other duties as assigned.
Behavioral Standards
Support the mission, vision, and goals of Avem Health Partners and serve as a role model within the company.
Exhibit positive customer service behavior in everyday work interactions.
Demonstrate a courteous and respectful attitude to internal workforce and external customers.
Communicate accurately and appropriately.
Handle difficult situations discreetly and professionally.
Hold self‑accountable for professional practice.
Demonstrate knowledge of unit goals and be active in committees and projects to achieve these goals.
Keep current with literature regarding changing practices, interventions, and best practices in patient care.
Seek educational and professional opportunities for personal growth and meet mandatory education requirements.
Act as a preceptor when requested.
Demonstrate excellent work attendance and participate in meetings and training sessions as required.
Adhere to the Avem Health Partners Code of Conduct and Standards of Behavior, policies, procedures, and all health and safety requirements.
Education
High school diploma or equivalent.
At least two years of medical accounts receivable experience.
Certification / Licensure
Medical billing certification, if available.
Physical Requirements
Perform each essential job duty satisfactorily.
Knowledge, skill, and/or ability required, with reasonable accommodations available for disabilities.
Needs visual and auditory abilities to perform duties.
Seniority Level Entry level
Employment Type Full‑time
Job Function Accounting/Auditing and Finance
Industries Business Consulting and Services
#J-18808-Ljbffr