Description

The Accounts Receivable Clerk will be responsible for managing the revenue cycle processes related to ancillary service billing, including laboratory and mammography services. This role supports accurate billing, timely collections and effective accounts receivable management for medical ancillary practice. The ideal candidate will have a strong background in healthcare billing, particularly lab and diagnostic imaging, along with excellent communication skills, and a commitment to accuracy and efficiency in financial operations.

Responsibilities:

• Ancillary Billing and Claims Processing: Generate, review and submit accurate electronic and paper claims for laboratory and mammography services, ensuring correct use of CPT/HCPCS codes, modifiers, diagnosis codes and payer-specific billing requirements. Verify patient insurance coverage, eligibility, and benefits prior to billing and ensure proper authorization for services. Review and resolve claim rejections, denials, and discrepancies in a timely manner. Monitor and follow up on outstanding claims to ensure prompt and accurate reimbursement.
• Accounts Receivable Management: Post payments, adjustments, and denials accurately to patient accounts in the billing system. Reconcile payments received with remittance advice and deposit reports from insurance companies. Investigate and resolve billing inquiries and discrepancies from patients, insurance companies, and internal departments. Maintain accurate and up-to-date accounts receivable aging reports and follow up on overdue balances.
• Collections and Revenue Cycle Optimization: Initiate collection efforts for outstanding patient balances through phone calls, letters, and other communication methods. Implement and adhere to established billing and collections policies and procedures to maximize revenue capture and minimize bad debt. Identify trends and patterns in accounts receivable and recommend process improvements to enhance revenue cycle performance.
• Financial Reporting and Analysis: Prepare and distribute regular reports on accounts receivable metrics, aging analysis, and collection performance to management. Assist in month-end close processes, including reconciliation of accounts receivable sub-ledger to general ledger.
• Compliance and Documentation: Ensure compliance with billing regulations, coding guidelines, and healthcare privacy laws (e.g., HIPAA). Maintain accurate documentation of billing and collections activities in accordance with regulatory requirements and organizational policies.

Requirements

• High school diploma or equivalent required; Associate's degree in accounting, finance, or related field preferred.
• Minimum of 2-3 years of experience in healthcare accounts receivable, medical billing, or revenue cycle management.
• Proficiency in medical billing software and electronic health record (EHR) systems (e.g., EPIC, Cerner, NextGen).
• Knowledge of healthcare billing and coding processes, including CPT and ICD-10 coding principles.
• Strong analytical skills with the ability to interpret and analyze financial data and reports.
• Excellent communication, interpersonal, and customer service skills.
• Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced healthcare environment.