Medical Accounts Receivable Specialist Job Description [Updated for 2024]

In the ever-evolving world of healthcare, the role of Medical Accounts Receivable Specialists is increasingly critical.

As the healthcare industry continues to grow and transform, the demand for skilled professionals who can proficiently manage, track, and optimize medical revenues is on the rise.

But what exactly is expected from a Medical Accounts Receivable Specialist?

Whether you are:

• A job seeker aiming to understand the core of this role,
• A hiring manager outlining the perfect candidate,
• Or simply fascinated by the complexities of healthcare finance,

You’re in the right place.

Today, we present a comprehensive and customizable Medical Accounts Receivable Specialist job description template, crafted for effortless posting on job boards or career sites.

Let’s delve into it.

Medical Accounts Receivable Specialist Duties and Responsibilities

Medical Accounts Receivable Specialists play a crucial role in the healthcare industry, ensuring that healthcare providers are paid for the services they provide.

They are responsible for billing and collecting payments from patients and insurance companies.

Their main duties and responsibilities include:

• Processing claims and billing insurance companies for medical services
• Reviewing and appealing unpaid and denied claims
• Verifying patients’ insurance coverage
• Answering patients’ billing and payment questions
• Identifying and resolving patient billing complaints
• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing
• Following up on unpaid claims within standard billing cycle timeframe
• Checking each insurance payment for accuracy and compliance with contract discount
• Calling insurance companies regarding any discrepancy in payments if necessary
• Maintaining patient accounts by updating account information
• Maintaining strict confidentiality in accordance with HIPAA regulations
• Keeping track of billing and collection activities

 

Medical Accounts Receivable Specialist Job Description Template

Job Brief

We are seeking a detail-oriented Medical Accounts Receivable Specialist to handle medical billing and collections for our healthcare facility.

The individual will be responsible for submitting medical claims to insurance companies and payers such as Medicare and Medicaid.

The ideal candidate should be familiar with medical billing procedures, coding, and patient data entry systems.

They should also have excellent communication skills to liaise with insurance companies, medical providers, and patients.

 

Responsibilities

• Submit medical claims to insurance companies and payers such as Medicare and Medicaid.
• Perform posting charges and completion of claims to payers.
• Review patient bills for accuracy and completeness, and obtain any missing information.
• Follow up on unpaid claims within standard billing cycle timeframe.
• Check each insurance payment for accuracy and compliance with contract discount.
• Call insurance companies regarding any discrepancy in payments.
• Identify and bill secondary or tertiary insurances.
• Review all insurance denial reasons and resubmit claims or file appeal as necessary.
• Maintain patient confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).

 

Qualifications

• Proven working experience as a Medical Accounts Receivable Specialist or similar role.
• Knowledge of billing procedures and collection techniques (e.g., skip tracing).
• Familiarity with medical terminology and healthcare regulations.
• Proficiency with MS Office and databases.
• Excellent communication and data entry skills.
• Attention to detail and problem-solving ability.
• Understanding of medical coding and billing software.
• High school diploma; degree in Business Administration or related field is a plus.

 

Benefits

• Health, dental and vision insurance
• 401(k) retirement plan
• Paid time off
• Continuing education opportunities
• Life insurance
• Wellness programs

 

Additional Information

• Job Title: Medical Accounts Receivable Specialist
• Work Environment: Office setting within a healthcare facility. The role may require occasional visits to medical departments.
• Reporting Structure: Reports to the Billing and Collections Supervisor.
• Salary: Salary is based upon candidate experience and qualifications, as well as market and business considerations.
• Pay Range: $38,000 minimum to $55,000 maximum
• Location: [City, State] (specify the location or indicate if remote)
• Employment Type: Full-time
• Equal Opportunity Statement: We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
• Application Instructions: Please submit your resume and a cover letter outlining your qualifications and experience to [email address or application portal].

 

What Does a Medical Accounts Receivable Specialist Do?

Medical Accounts Receivable Specialists primarily work in healthcare settings such as hospitals, clinics, and medical offices.

Their main role is to manage and maintain the accounts receivable department and ensure the accuracy of invoicing within the healthcare organization.

They are responsible for processing medical billing transactions, including posting payments and adjustments to patient accounts.

A significant part of their job involves communicating with patients, insurance companies, and healthcare providers to resolve any billing discrepancies.

Medical Accounts Receivable Specialists also perform routine audits of patient accounts to ensure that all charges are correctly posted and that all payments, adjustments, and write-offs are properly applied.

They are tasked with reviewing and analyzing outstanding insurance claims, identifying trends, and helping to implement solutions to reduce the number of denied and unpaid claims.

Moreover, these professionals are usually in charge of collections, which involves contacting patients regarding unpaid accounts, setting up payment arrangements, and potentially referring accounts to collection agencies.

When necessary, a Medical Accounts Receivable Specialist may assist in the preparation of financial and statistical reports related to accounts receivable and patient accounting.

 

Medical Accounts Receivable Specialist Qualifications and Skills

A proficient Medical Accounts Receivable Specialist should have the qualifications and skills that align with your job description, such as:

• Knowledge of medical billing procedures to handle all accounts receivable duties accurately.
• Proficiency in utilizing medical software for managing patients’ medical records and billing data.
• Strong numerical and analytical skills to accurately calculate and verify billing data.
• Exceptional attention to detail to ensure accurate entry of information, ensuring there are no discrepancies in patients’ accounts.
• Excellent communication skills to liaise with insurance companies, healthcare providers, and patients regarding outstanding payments.
• Ability to manage time effectively and prioritize tasks to meet payment collection deadlines.
• Strong problem-solving skills to resolve any issues or discrepancies that may arise in medical billing or payments.
• Knowledge of medical coding and terminology to accurately interpret and record medical services provided.
• Customer service skills to address any billing concerns or queries from patients in a professional and empathetic manner.

 

Medical Accounts Receivable Specialist Experience Requirements

Entry-level candidates for a Medical Accounts Receivable Specialist role typically require at least 1 to 2 years of experience in a related financial or medical administrative field.

This experience can be gained through internships or part-time roles in medical billing or coding, financial administration, or patient account services.

Candidates with more than 2 years of experience may have honed their skills in healthcare billing systems, insurance claim processing, and patient record management.

This extensive experience is usually required for roles that involve complex patient accounting tasks or direct interaction with healthcare providers and insurance companies.

Those with more than 5 years of experience as a Medical Accounts Receivable Specialist may have a strong background in medical accounting practices, regulatory compliance, and team leadership.

They are often ready for supervisory or managerial roles within the medical accounting or administrative department of a healthcare institution.

In addition, professionals in this field often hold a certification from a recognized organization like the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA).

This demonstrates an advanced level of knowledge and expertise in medical coding and billing.

 

Medical Accounts Receivable Specialist Education and Training Requirements

Medical Accounts Receivable Specialists typically have a high school diploma or equivalent.

However, most employers prefer candidates with an associate’s or bachelor’s degree in finance, accounting, or a related field.

In addition to a formal education, they should have a strong understanding of medical billing and coding procedures.

Knowledge of health insurance processes, medical terminology, and data entry skills are also crucial for this role.

While not always required, obtaining a certification as a Certified Medical Reimbursement Specialist (CMRS) or a Certified Revenue Cycle Specialist (CRCS) can enhance job prospects.

These certification programs often cover topics such as health insurance and managed care, billing, coding, patient accounting, medical records, regulatory guidelines, and compliance.

Continued professional development is also important in this role as insurance billing codes, medical regulations, and healthcare policies often change.

Some employers may also require candidates to have experience with specific software used in healthcare billing and coding.

Having strong customer service skills is also beneficial as Medical Accounts Receivable Specialists may need to handle patient inquiries and disputes.

 

Medical Accounts Receivable Specialist Salary Expectations

A Medical Accounts Receivable Specialist earns an average salary of $37,907 (USD) per year.

The actual earnings may vary based on experience, education, location, and the size of the employing company or medical facility.

 

Medical Accounts Receivable Specialist Job Description FAQs

What skills does a Medical Accounts Receivable Specialist need?

A Medical Accounts Receivable Specialist needs to have strong analytical and problem-solving skills to effectively manage billing issues.

They should have excellent attention to detail to ensure accuracy in managing accounts and invoices.

Proficiency in medical billing software and a strong understanding of medical terminology and healthcare regulations is also important.

Good communication and interpersonal skills are necessary to interact with patients, insurance companies, and healthcare providers.

 

Do Medical Accounts Receivable Specialists need a degree?

While a high school diploma or equivalent is often the minimum requirement, many employers prefer candidates who have an associate’s or bachelor’s degree in healthcare administration, finance, or a related field.

Some roles may require specific certification in medical billing or coding.

 

What should you look for in a Medical Accounts Receivable Specialist resume?

A strong Medical Accounts Receivable Specialist resume should highlight relevant education and certification, as well as experience in medical billing or healthcare administration.

Look for demonstrated knowledge in healthcare regulations and medical terminology.

Proficiency in using medical billing software and handling patient accounts should also be evident.

 

What qualities make a good Medical Accounts Receivable Specialist?

A good Medical Accounts Receivable Specialist is highly organized and detail-oriented, ensuring accuracy in managing and recording financial information.

They should be strong problem solvers, capable of handling billing discrepancies or issues.

Good interpersonal and communication skills are important for dealing with patients, insurance providers, and healthcare professionals.

A commitment to maintaining patient confidentiality and adhering to healthcare regulations is also vital.

 

What are the daily duties of a Medical Accounts Receivable Specialist?

A Medical Accounts Receivable Specialist typically starts the day reviewing patient accounts and updating billing records.

They might spend a significant part of their day on the phone, discussing billing issues with insurance companies or patients.

They also handle billing inquiries, process payments, and investigate any discrepancies.

Regular communication with healthcare providers is also a part of their routine, ensuring all services are accurately billed and paid for.

 

Conclusion

And there you have it.

Today, we’ve unveiled the core intricacies of what being a Medical Accounts Receivable Specialist truly means.

And guess what?

It’s not just about dealing with numbers.

It’s about ensuring the seamless financial operations of healthcare facilities, one account at a time.

With our ultimate Medical Accounts Receivable Specialist job description template and real-life examples, you’re fully equipped to take the next step.

But why end your journey here?

Explore further with our job description generator. It’s your pathway to creating laser-sharp job listings or optimizing your resume to absolute excellence.

Remember:

Every account processed plays a pivotal role in the bigger picture.

Let’s shape a healthier financial future. Together.

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