Account receivable specialist role and responsiblity

Account receivable process

In Medical billing one of the key functionality, and the biggest department of Medical Billing, in other words, the Accounts Receivables (AR) Department. It is the pivot department, which makes the other departments revolve around it. It can also be called as the back-bone of medical billing. It is the financial department of Medical Billing as only this department deals with the payment of the claims, and acts on the receivables that are outstanding to bring in the money. It is only based on this department, the revenue of the Doctor as well as the Billing Company is determined. The more proactive and aggressive is this department, the more the revenue will be. So let’s talk about this department.

Accounts Receivables is broadly classified into two sub-departments, they are AR Analysis and AR Calling. Let’s look at AR Analysis briefly.

Analysis is the most important part of billing. An AR Analyst is a person, who monitors the receivables to ensure that it is well within control. He should also keep in mind that the main objective of a billing company is to maximize collections. He should work towards the common goal and create methods to make sure the goal is attained. For this purpose, the analyst should set targets every month of what the collections would be for that month taking into account various factors such as the average turnaround time and unresolved issues. Therefore there are two major functions of an analyst – Maximizing collections and reducing the receivables.

The other basic duties of an Analyst are as follows:

1. Constantly keep track of both electronic and paper claims.

2. Always be watchful for any major rejections or denials –clearing house/carrier.

3. Constantly watch-out for payments and EOBs from major carriers, Pay-to address, provider numbers etc.

4. Ensure the AR days meet industry standards.

5. Co-ordinate with the Call Center crew, Client co-ordination and solve problems.

6. Ensuring the compliance with all the insurance carriers in claims submission and other areas.

An Analyst apart from these above mentioned duties should also maintain various reports in order to send it to the Doctor’s office for his evaluation. The reports that are generated are:

1. Daily Reports: This report gives the value of charges, insurance receipts, patient receipts, write-offs and charge adjustments and the number of procedure units entered on a particular accounting date and the gross AR as on that date for the Doctor.

2. Production Reports: This report shows the number of demographics, charge, and cash entered by the data entry staff for the calendar date specified.

3. Month End Reports and Financials: This report gives the total summary of the charges entered, cash received, outstanding payment, total Doctor’s revenue of that month, and the comparison chart showing the payment of the previous month, statistics, and the whole of that month’s payment, and collections. This report must be sent to the Doctor at the end of every month.