Position Title: Medical Claims & Billing SpecialistDepartment: Insurance & BillingReports To: Insurance & Revenue Cycle CoordinatorEmployment Type: Full-time or Part-timePosition Overview:The Accounts Receivable Specialist at kin:pathic plays a crucial role in ensuring the accuracy and timeliness of invoicing and payment processes. This role involves working closely with the Insurance and Administrative teams and requires strong teamwork and time management skills. Excellent verbal and written communication skills are essential for interacting with payors and client families.Who You Are:You are a detail-oriented, organized, and proactive individual with strong communication skills. You exhibit the company's values in your day-to-day interactions and demonstrate proficiency in financial processes.Primary Roles and Responsibilities:Accounts Receivable & CollectionsTrack and manage outstanding AR balances across payers and clientsFollow up on unpaid or underpaid claims with insurance companiesIdentify trends in denials or delays and escalate when appropriateMaintain AR aging reports and prioritize follow-upsDocument payment denials and follow up appropriately.Denials & Payment ResolutionInvestigate and resolve claim denials, including authorization issues, coding errors, or credentialing discrepanciesPrepare and submit appeals with supporting documentationWork collaboratively with clinical, intake, and credentialing teams to resolve issuesDatabase Management:Manage databases relevant to client services and billing.Maintain accurate and organized records in accordance with company policies and procedures.Invoicing:Prepare and process invoices for a variety of clients.Verify the accuracy of invoices, including client information, billing and service codes, and insurance coverage information.Resolve any discrepancies during the invoicing process.Payment Posting & ReconciliationAccurately apply patient and district payments in billing systems Reconcile payments with Explanation of Benefits (EOBs) and remittance adviceIdentify discrepancies and ensure proper allocation of paymentsCommunication:Communicate clearly with families regarding balances, deductibles, and patient responsibilityProvide support via phone and email to answer billing-related questionsAssist with payment plans or coordination of benefits when neededCommunicate payors to resolve issues.Collaborate with the Administrative and Insurance teams.Prepare and submit documentation to insurance companies as needed.Compliance:Stay up-to-date on all company standards and federal/state standards required for the invoicing process.Reporting & Process ImprovementGenerate and review AR reports (aging, billing ledger, authorization utilization)Identify opportunities to improve billing workflows and reduce AR daysAssist with year-end reconciliation and invoicing projectsMeetings and Training:Attend meetings as scheduled.Participate in required company training.Qualifications:Bachelors degree in a related field preferred.3+ years of experience in billing, invoicing, accounts receivable, or a related field.Knowledge of insurance and medical services.Excellent written and verbal communication skills.Strong organizational and time management abilities.Ability to learn and understand company databases and software applications.Strong problem-solving skills.Ability to prioritize tasks and meet deadlines.
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