Accounts Receivable Specialist- Community Health

Join a Team That Makes a Difference at Optimus Health Care!

Are you passionate about providing high-quality, patient-centered care? Optimus Health Care—the largest provider of primary health care services in Fairfield County—is looking for dedicated professionals to join our team! With multiple locations in Bridgeport, Stratford, and Stamford, our mission is to be a lifelong health care partner, dedicated to achieving optimal wellness for the communities we serve.

Optimus Healthcare is looking for a full-time Account Receivable Specialist with at least two years of healthcare experience to join our team in Stratford, CT.

The Account Receivable Specialist will be responsible for performing all tasks related to the billing, cash posting, follow-up, charge review, self-pay, and collections functions for Optimus Health Care.

Essential Functions & Responsibilities

• Research all information needed to complete billing processing including correction of prebilling errors to ensure compliance with regulatory guidelines at time of billing.
• Review of claim batches, making appropriate corrections for claims to be accepted by clearing house.
• File all claims daily (electronic claims and hard copy).
• Post charges and any corrections to charges to ensure integrity of account information.
• Analyze billing reports to ensure proper billing procedures are followed based on federal and state rules and regulations.
• Review and analyze health care clinicians claims and identify trends and issues within the revenue cycle process.
• Post all insurance and patient payments received and reconcile to the door sheet provided by finance each day.
• Research and resolve all collection related activities, including working through accounts receivables to maximize reimbursement.
• Function as a liaison between patients and clinic staff on claims, billing questions or insurance related issues.
• Trace errors, record adjustments to proper account and determine the appropriate destination of unidentified funds.
• Respond to inquiries from agencies and insurance companies to assist in claim payment processing.
• Effectively process all patient and third-party correspondence, including requests for copies of claims, statements, and refunds.
• Effectively process all legal documentation as it relates to patient accounts.
• Act as a resource to Clinicians, Administrators and patients regarding health insurance claim policies, procedures, and requirements.
• Provide support to the Billing department and management team on various areas of patient billing research and analysis.
• Research, trouble-shoot Accounts receivable reports and rejections, process appeals where appropriate, and make recommendation for write offs.
• Maintain compliance according to government insurance regulations and managed care contractual obligations.
• Maintain regulatory compliance by staying abreast of current trends and regulations in the financial and healthcare industries.
• Maintain assigned work queues to ensure timely action for charge posting, insurance follow up, and credits.
• Run standard billing reports from EMR for efficient and timely management of accounts receivables for insurance and patient collections.
  
  

Additional General Requirements

Professional positive attitude, vision, understanding of customer service principals, trustworthiness, and excellent communication and interpersonal skills to successfully accomplish tasks necessary to meet high standards of ethical and social responsibility required by this position.

Job Qualifications/Requirements

• Detail-oriented with excellent problem-solving abilities
• Experience with EMR (EPIC); Microsoft Word, Excel, PowerPoint, and other billing software applications
• Strong communication, verbal and written and interpersonal skills
• Ability to analyze and solve problems with limited assistance
• Ability to maintain confidentiality
• Demonstrated medical accounts receivable or insurance follow up background
• Attention to detail and accuracy
• Ability to meet deadlines
• Strong organization and prioritization skills
• Ability to work with a diverse group of people, providing excellent customer service
• Ability to work independently or as a team member
• Strong data entry Skills
• Analytical and problem-solving skills
  
  

EDUCATION: Associate or bachelor’s degree in finance, Healthcare Administration, or a related field. Certified Professional Coder (CPC) or similar certification is desirable

High School Diploma; (CPT4 and ICD9/ICD10), helpful.

EXPERIENCE: Minimum of 2 years' experience in medical billing, accounts receivable, or a similar role.

Proficient knowledge of medical terminology, ICD-10, and CPT codes.

LANGUAGE SKILLS: English/Spanish helpful

MATHEMATICAL SKILLS: Basic math skills

REASONING ABILITY: Critical thinking, analytical and problem-solving skills.

LICENSURE / CERTIFICATION: CCA or CPC certification

Optimus is committed to providing equal employment opportunities to all applicants and employees as protected by applicable federal and/or state law