Accounts Receivable Specialist


Job Description
Duties and Responsibilities:
- Contact insurance carriers daily to follow up on past due amounts on outstanding medical claims by calling carriers, utilizing payer web portals, and working in tandem with your team.
- Have a working knowledge of In and Out of Network reimbursement processes/methodologies.
- Investigate and resolve claims that have been submitted to insurance for payment and create detailed follow-up notes that provide summary of actions taken and collection status.
- Investigate and collect information related to claims denials and determine when it’s appropriate to file reconsiderations and/or appeals needed to contest incorrect insurance determinations.
- Collaborate daily with other departments within RCM to resolve claims processing issues and work to ensure timely processing and reimbursement of assigned insurance carriers.
- Work with AR Management to identify and resolve outstanding payer issues and trends as they arise and be able to effectively handle insurance claims specialists with a strategic and systematic approach.
- Provide high quality customer service to our clients, including but not limited to, calling clients to discuss their insurance coverage, coordination of benefits, lapses in coverage and more.
- Comply with and maintain integrity of confidential information, security policies, procedures, and PHI.
Knowledge, Skills and Abilities Required:
- Ability to work independently with minimal supervision and manage multiple priorities in a remote work environment.
- 3+ years of experience managing medical receivables with a track record of success.
- Experience working both in and out of network environments is a plus.
- Strong analytical and mathematical skills with the ability to identify trends and opportunities for process improvement.
- Ability to communicate clearly and effectively, both written and orally.
- Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
- Experience using Excel; from basic formulas up to compiling ad-hoc reports for global claims projects.
- Ability to work within multiple systems to locate information needed to support claims research and resolution.
- High School Diploma required, bachelor’s degree in business/management or related area (or equivalent experience in revenue cycle management) preferred.
- In-depth knowledge of medical and insurance terminology and guidelines.
- Austin, TX candidates preferred but will consider remote work for applicants with the right background.
- Experience working in Central Reach practice management system preferred.
- Experience working in Applied Behavioral Analysis preferred.
- Generous Paid Time Off: 22 paid days off in year 1: 10 holidays, 10 paid days, PLUS 2 flex days
- Industry-leading benefits: Student Loan Repayment, Maternity/Paternity Award of up to $3,000, HSA for child care, Short Term Disability options, BCBA sabbatical, Calm App and DoorDash subscriptions
- 401K Retirement Plans with company matching
- Health Benefits covered up to 90%!
- Mission and Values based team culture
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Teaching skills to change lives – not labels
As a BCBA at Action Behavior, you play a pivotal role in transforming the lives of the children we serve. Your expertise and dedication ensure that we fulfill our promises to our families:
We promise to celebrate your child’s individuality
We promise to help your child reach milestone moments
We promise to advocate for your child in everything we do
We promise to honor your family’s dynamics and values
Your journey is just beginning
At Action Behavior, we support your continued learning and career growth as a BCBA through our best-in-class professional curriculum, education, and skill-enhancement opportunities. Nourishing excellence is essential for helping our teammates grow!
Our training is built on three core principles:
- Helping teammates learn the basics of ABA therapy
- Staying updated with research
- Improving clinical skills
Before you apply
Everything you need to know.