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Robert Half Medical Accounts Receivable Specialist in Sandy Springs, Georgia


The Accounts Receivable Coordinator II is responsible for the timely follow-up and collection of payments including but not limited to third party payer receivables. This position is the main point of contact between the facility and third-party payers to ensure maximum reimbursement is achieved and aging of receivables is minimized.

The Accounts Receivable Coordinator II files third-party insurance, Medicare and Commercial claims daily as directed by the Director of Revenue Cycle. This position also pursues outstanding accounts and performs verification and prior authorizations.

Coordinate all insurance verifications and prior authorizations for pharmacy clients

File third-party insurance, drug card, and Medicare claims daily for assigned accounts and serve as backup for other accounts as needed.
  • Mail monthly billing statements to clients with third-party insurance and Medicare

for assigned accounts and provide backup for other accounts as needed.

  • Review, investigate (if needed), and initial adjustments for client accounts prior to submitting them to the Director of Revenue Cycle to initial. The Director of Revenue Cycle submits them to the VP of Operations for approval.

  • Research and solve payment discrepancies.

  • Process correspondence and follow-up related to assigned accounts and provide backup duties for other accounts as needed.

  • Research denied and improperly processed claims by contacting payers to ensure proper processing of said claims.

  • Maintain denial reports and coordinate appeals ensuring that all notes are properly documented.

  • Ensure all assigned accounts are resolved timely and effectively in compliance with established policy and procedures.

  • Identify and attempt to resolve any issue preventing or slowing reimbursement.

  • Serve as a back-up to the Director of Revenue Cycle to create invoices and CMS inventory reports daily.

  • Stay updated on all third-party billing requirements and changes.

  • Gather documentation and generate refund letters to insurance companies and Medicare.

  • File insurance paperwork and ensure client’s insurance information in CMS is current.

  • Monthly send Client Assistance Program (CAP) letters to clients if they have a balance on their account.

  • Maintain and track Order Summary forms for Medicare, Medicare/Medicaid crossovers. Actively pursue outstanding forms. Update Order Summaries’ list in CMS as they are received.

  • Maintain current A/R notes in Great Plains starting with the date billed. Once the claim has been paid, notes can be deleted and printed to attach with paid claim to file. Code payments received daily (except Medicaid).

  • Pull electronic remittances from Solace/payer portals and code Medicare/Commercial payments. Pull electronic remittance advices for other third-party payers.

  • Coordinate all insurance verifications for pharmacy clients attending Camp Wannaklot.

  • Provide first-class customer service to all customers—both internal and external.

  • Be accountable for maintaining ideal revenue cycles and reducing A/R days.

  • Work with the VP of Human Resources to maintain and update A/R procedures as needed


Medical billing and coding certification

· At least 3 years’ experience in billing and collecting healthcare claims

· Familiarity with on-line billing software and ability to learn new software programs.

  • Ability to maintain confidentialit

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