Accounts Receivable Specialist
Eskenazi Health


Job Info


Division:Eskenazi Health

Sub-Division:Hospital

Req ID:10831

Schedule:Full Time

Shift:Days

Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 327-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus as well as at 10 Eskenazi Health Center sites located throughout Indianapolis.

FLSA Status

Non-Exempt

Job Role Summary

The Accounts Receivable Specialist reviews and follows up on all claims not paid by carriers in a timely manner and claims not paid appropriately. This position reviews reports to determine trends and discusses with management to help resolve front-end errors. The Accounts Receivable Specialist calls insurance carriers and writes appeals as necessary for appropriate and compliant payment of claims.

Essential Functions and Responsibilities

  • Proactively contributes to Eskenazi Health's mission; models Eskenazi Health values
    • Adheres to customer-oriented turnaround timeframes; follows up on patient calls within the same date
    • Maintains department production, reduction of accounts receivable by bringing payments in and meets quality goals on a daily basis
    • Maintains productive and professional interactions with all insurance carriers and co-workers and all team members within and outside of Eskenazi Health
    • Conveys expected service message of positive assistance and support
    • Acts independently to resolve problems, seeking guidance when necessary and remains compliant with all rules and regulations for medical policy
    • Initiates the proper course of action for problem resolution based on job knowledge and experience
    • Demonstrates ability to access patient information by using multiple applications
    • Determines the caller's needs and takes appropriate actions
    • Re-bills claims as necessary, always contacting the carrier first to see what they need to process claims appropriately
    • Analyzes all claim denials to determine the best course of action to resolve any issue and receive appropriate payment
    • Verifies and updates all claims when insurance and other information changes need to be made
    • Ensures patient demographic information is the most accurate when speaking to the patient or read notes when there are address or phone issues reaching the patient
    • Bills and follows-up on new and aging accounts receivable
    • Resolves inquiries from internal and external customers
    • Takes active role in special projects as requested
    • Gathers and distributes insurance information obtained through verbal and/or written communication for the purpose of maintaining sufficient cash flow
    • Directs and answers inquiries regarding patient accounts to/from patients (if the call center is not able to respond), agencies, and third party payers
    • Updates patient contact information within various patient financial systems for the self-pay outsource vendor as necessary
    • Analyzes and resolves issues reported from the self-pay outsource vendor; reports from vendor provided weekly
    • Maintains productivity and quality assurance outlined by the department
    • Concentrates on call handling time as identified by the department
    • Utilizes interpersonal communication strategies/skills to achieve desired outcome/results with patients/families and others
    • Provides coverage for co-workers as necessary due to PTO/illness
    • May be responsible for maintaining the life of a claim which may include the following actions: Charge Entry, Claim Rejection, Claim Edit, Denial, Follow-up, No Response, Variance, Correspondence and Credit Balance Resolution
    • Continues knowledge based learning on payor guidelines and requirements for appropriate billing

Job Requirements

Three years of experience in medical practice setting working account follow-up and insurance appeals preferred. High School diploma or equivalent required; Associate Degree in business-related field preferred
  • CPC certification a plus
  • Dental, vision and/or DME coding a plus

Knowledge, Skills & Abilities

  • Pays close attention to detail; accuracy in record keeping and documentation
  • Identifies trends with denials (providers/locations/carriers) and works with management to help educate or resolve errors from the start and avoid back-end denials
  • Willingness and ability to assist other team members
  • Excellent problem-solving skills and ability to cooperate with others
  • Minimum keyboarding proficiency of 40-60 words per minute required
  • Works independently and efficiently
  • Working knowledge of Microsoft Office Software, Windows
  • Utilizes adding machine, printers, copiers, and fax machines
  • Strong math skills
  • Strong organizational skills and ability to work efficiently in a multi-task environment meeting deadlines
  • Uses professional and appropriate communication skills
  • Advanced understanding of health insurance medical policy and billing requirements, including government and managed care programs as well as traditional Medicaid, Medicare replacement plans, commercial carriers, HIP, Anthem
  • Ability to meet production and accuracy requirements outlined by department goals

Accredited by The Joint Commission and named one of the nation's 150 best places to work by Becker's Hospital Review for four consecutive years and Forbes list of best places to work for women, and Forbes list of America's best midsize employers' Eskenazi Health's programs have received national recognition while also offering new health care opportunities to the local community. As the sponsoring hospital for Indianapolis Emergency Medical Services, the city's primary EMS provider, Eskenazi Health is also home to the first adult Level I trauma center in Indiana, the only verified adult burn center in Indiana, the first community mental health center in Indiana and the Eskenazi Health Center Primary Care - Center of Excellence in Women's Health, just to name a few.

Nearest Major Market: Indianapolis



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