Accounts Receivable Specialist - Weill Cornell Medical College (New York, NY)

Under supervision and through the use of the PO's GE Centricity Business (formerly IDX) practice management system, the Accounts Receivable Specialist performs billing and accounts activities that will maximize insurance reimbursement and promote faster payments. Position Activities • Reviews insurance receivable for departments and notifies manager of potential problems. Performs extensive account follow-up activities through the GE Centricity Business (GE CB) Enterprise Task Manager (ETM) module. Investigates and analyses problem accounts. Takes appropriate action, adjustments, write-offs and makes collection referrals on delinquent accounts. Utilizes explanation of benefits to post rejection codes into the GE CB rejection module. Researches accounts and resolves disputes. • Performs extensive follow-up on unpaid insurance claims. Contacts third parties to expedite payments. Contacts patients to enlist cooperation. Monitors payment patterns and alerts management to deviations. Prepares letters of appeal to insurance carriers that were paid at the incorrect rate. Appeals denied claims. Answers inquiries from patients and insurance companies regarding unpaid physician charges by utilizing the GE CB practice management system. Explains billing procedures and communicates with third party payers eligibility, misdirected payments, billing problems and disputes • Utilizes tools such as GE Eligibility, WebMD, J.P. Morgan Receivables Edge, and insurance company websites to expedite the account follow-up process. Utilizes other computer applications such as WMC EpicCare and the NYPH Eagle system, retrieve and update patient insurance and demographic information and enter it into the GE CB system. • Responds to requests for information from patients and insurance carriers by retrieving source documents such as Radiology reports, medical records and referrals. Prepares charge corrections as needed. Updates patient demographic and insurance information in the GE CB billing system. Processes insurance information to ensure that a claim is generated via electronic media or paper. Develops work schedules with manager for aggressive account follow-up. • Follow-up on ticklers through the ETM system for aggressive account follow-up. Makes appropriate corrections to system to satisfy system edit requirements and re-submit claims as needed. Refers accounts to In House Collection division for further follow-up. Explains billing procedures to patients and insurance companies in accordance with departmental and PO Billing Policies and Procedures. • On an as needed basis, sorts and processes incoming correspondence to various divisions within the business office as well as various departments with the institution. Files and retrieves documents as needed. Participate in the monthly packing of documents to storage. Attends seminars and workshops to stay abreast of changes and new information in the field.

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