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AR Executive

2 weeks ago

Lahore, Punjab, Pakistan Prima Systems Full time

Job description:

Digital Prima Systems is a reputable healthcare technology company specializing in providing innovative solutions for medical billing and revenue cycle management. We are committed to assisting healthcare providers in optimizing their financial operations and ensuring timely reimbursement for services rendered.

Responsibilities:

  • Insurance Claims Processing:
  • Review and prepare accurate insurance claims for submission to various payers.
  • Verify patient insurance coverage, benefits, and eligibility.
  • Ensure proper coding (CPT, ICD-10, HCPCS) and documentation for claims accuracy.
  • Submit claims electronically or by paper according to payer requirements.
  • Payment Posting and Reconciliation:
  • Post payments received from insurance companies and patients into the billing system.
  • Reconcile payments against billed amounts to identify discrepancies.
  • Investigate and resolve any discrepancies in payments, adjustments, or denials.
  • Accounts Receivable Management:
  • Monitor and follow up on unpaid or denied claims to ensure timely resolution.
  • Contact insurance companies to inquire about claim status and facilitate payment.
  • Review aging reports regularly to prioritize and address delinquent accounts.
  • Initiate appeals for denied or underpaid claims and track the appeal process.
  • Patient Billing and Communication:
  • Generate patient statements and invoices for outstanding balances.
  • Work with patients to establish payment plans or arrangements.
  • Provide clear and compassionate communication regarding billing inquiries or issues.
  • Documentation and Reporting:
  • Maintain accurate and organized records of all billing and collection activities.
  • Generate reports on accounts receivable status, aging trends, and collection efforts.
  • Prepare regular updates and summaries for management review.
  • Compliance and Regulations:
  • Ensure compliance with HIPAA regulations and other billing guidelines.
  • Stay informed about changes in billing regulations and payer policies.
  • Implement best practices to maximize reimbursement and minimize compliance risks.

Requirements:

  • Proven experience as an Accounts Receivable Specialist in medical billing or a related field.
  • In-depth knowledge of medical terminology, billing codes (CPT, ICD-10, HCPCS), and insurance claims processes.
  • Proficiency in using medical billing software and electronic health record (EHR) systems.
  • Strong understanding of insurance policies, reimbursement methodologies, and billing guidelines.
  • Excellent analytical skills to identify and resolve billing discrepancies efficiently.
  • Effective communication skills to interact professionally with insurance companies, patients, and internal teams.
  • Detail-oriented with a high level of accuracy in data entry and financial calculations.