Us Heart and Vascular is in need of an Accounts Receivable Specialist to join our Houston Cardiovascular Associates in Houston, TX.

Responsibilities:

• Responsible for billing all patient claims in a timely manner
• Perform extensive claims follow up activities, utilizing the current Practice management (PM), and clearinghouse systems.
• Investigate, analyze, and resolve problematic and delinquent insurance claims.
• Work daily claims rejection lists including but not limited to, eligibility, coordination of benefits, clearinghouse smart edits, etc.
• Responsible for appeals management – 1st, 2nd and ADJ level appeals as well as peer-to-peer reviews.
• Utilize clinical applications, payer websites and other systems as a research tool to retrieve medical documentation, patient eligibility information, billing guidelines, patient referrals, and hospital or procedure code authorizations to substantiate corrected claims submissions, through written appeals, and coding reviews, etc.
• Establish and maintain effective working relationships with carrier representatives and internal and external clients.
• Collaborate with physicians and billing team to resolve coding and billing discrepancies
• Remain abreast of carrier/payer updates as it relates to Billing and Collections guidelines including claim submissions, claim appeals, grievance procedures and policy changes.

Requirements: