A/R Specialist is responsible for calling all insurance companies and utilizing online resources to check claim status, resubmit claims as necessary via paper or electronically, file appeals, track denial trending, resolve denials, and ensure maximum revenue capture. In addition, this role will facilitate timely receipt of payments and ensure balances on accounts are correct and appropriately prorated.
Responsibilities:
Follow up on all assigned insurance claims to ensure appropriate reimbursement
Identify, investigate, and resolve unpaid claims
Process assigned AR task lists to meet daily production goals as assigned by management
Review accounts to determine appropriate follow-up action
File claim denials and underpayments for resubmission considerations and appeals
Recommend accounts to be written off as per adjustment guidelines and prepare refunds upon approval
Report filing rule changes to the manager upon discovery or notification
Properly notate patient accounts as per RCM workflow and procedures
Scan correspondence and index to the paper account as per RCM workflow and procedures
Respond to all insurance company and patient inquiries regarding claim
Maintain an acceptable error rate vs. productivity level per assigned goals
Perform collection actions, including third-party appeals and the resubmission of claims to third party payers
Identify and bill secondary or tertiary insurances
Reconcile carrier submissions, edits, and rejection reports
Execute duties of position in a professional and courteous manner
Handle sensitive information in a confidential manner
Performs all other duties as assigned
Eligibility and Authorization
Payment posting
Qualifications:
High School Graduate or General Education Degree (GED)
1 years of professional medical billing /AR experience preferred but willing to hire right out of medical billing school
Strong attention to detail with a dedication to accuracy
Excellent verbal and written communication skills
Highly energetic with a positive attitude
Possess strong written and verbal communication skills
Create and maintain positive interpersonal relationships
Ability to perform as part of a team as well as work independently
Understand medical terminology and can read a medical record
Certification obtained from a nationally accredited billing program, i.e., CMBS (Certified Medical Billing Specialist) preferred but not required
Experience with Excel and Windows-based programs preferred
Experience in performing tasks that require a basic understanding of accounting and math skills
Experience with EPIC a huge plus but not required
Job Type: Full-time
Pay: $18.00 - $20.00 per hour
Benefits:
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
Experience:
- ICD-10: 1 year (Preferred)
Work Location: Remote