Account Receivable Officer at Tranquil & Quest Medical and Diagnostics Limited

Position Overview

This position offers a great opportunity for career growth. The Accounts Receivable Officer is responsible for managing and ensuring accurate and timely collection of payments from patients, insurance companies, and third-party payors. This role involves monitoring accounts, addressing discrepancies, and ensuring compliance with billing regulations.

Key Responsibilities

• Ensure accurate and complete follow-up on accounts by understanding carrier-specific reimbursement processes, including eligibility discrepancies, claims form preparation (1500/UB04), DRG, per diem, and case rate reimbursements
• Contact government agencies, third-party payors, and patients/guarantors via phone, email, or online to resolve outstanding account balances
• Document all follow-up activity and communications in patient account notes
• Ensure proper posting of payments and adjustments; identify accounts for secondary billing and follow-up
• Research and review accounts for balance accuracy, correct payor billing, coding accuracy, denials, and outstanding insurance requests
• Provide necessary documentation, submit corrections, or escalate payor errors for re-processing
• Request additional information from patients and payors as needed
• Review payor contracts to determine expected reimbursements, identify underpayments, and draft payor demand letters
• Identify billing or coding issues and request re-bills, secondary billing, or corrected bills as necessary
• Track payor issues and trends, escalating them to management as appropriate
• Ensure compliance with State and Federal Laws and regulations for managed care and other third-party payors
• Perform other follow-up and administrative duties as requested by management

Required Qualifications & Skills

• Bachelor's degree in Accounting or related field
• Strong attention to detail
• Excellent communication skills
• Thorough understanding of claims processing and reimbursement procedures