AR Specialist - Healthcare Account

Overview:
The Medical Billing Specialist - AR will play a vital role in our team with the primary responsibility of handling all aspects of claims management, from investigation to resolution. The ideal candidates should have a strong understanding of medical billing practices and experience with insurance reimbursement processes. They should also have excellent communication and interpersonal skills and the ability to work efficiently and accurately under pressure. The ideal candidate exhibits extraordinary problem-solving and decision-making skills.

Responsibilities:
- Streamline Payment Posting: Efficiently post payments and reconcile patient accounts to ensure accuracy and timeliness in financial transactions.
- Navigate Payer Platforms: Utilize various payer websites proficiently to gather claims information and streamline the billing process.
- Analyze Denials and Aged Claims: Identify root causes for claim denials and aged claims, collaborating with the billing manager to devise effective solutions for resolution.
- Conduct Payer Communication: Engage with insurance companies via phone calls and online portals to obtain claims status and determine appropriate actions for resolution, maintaining a professional demeanor throughout interactions.
- Document Claims Status: Thoroughly document claims status and actions taken to facilitate clear communication and tracking of progress.
- Address Denials Promptly: Address and respond to denials promptly to ensure accurate payment of submitted bills and minimize revenue loss.
- Proactively Investigate Denials: Investigate reasons behind claim denials, analyze findings, and propose strategies for preventing future denials.
- Manage Claim Adjustments: Initiate necessary actions such as resubmitting claims, requesting reprocessing, or creating appeals based on analysis and investigation outcomes.
- Follow Up on Outstanding Claims: Diligently follow up on open and unpaid claims until resolution, preventing delays in reimbursement and ensuring a clear accounts receivable list.
- Provide Regular Reports: Furnish daily reports to Accounts Receivable Supervisor/Manager, offering updates on completed tasks and highlighting pending issues for attention.
- Maintain Accurate Records: Keep the Accounts Receivable system updated with comprehensive notes to facilitate efficient claim management and track progress effectively.

Qualifications and Skills:
- Proficient in healthcare revenue cycle roles, including registration, scheduling, billing, cash application, and denial management, with a focus on AR.
- Minimum 2 years of medical billing experience, preferably in AR-centric positions.
- Strong written and verbal communication skills.
- Ability to quickly grasp multiple Practice Management systems, access claims information, and navigate reports.
- Familiarity with navigating payer portals such as Availity, Optum, and insurance websites.
- Demonstrated commitment to learning and professional growth within an organization.
- High comfort level working on Eastern or Pacific Time Zone/US Shift
- Good internet access at home at least 25 MBPS

We'd love to get to know you better! Please send us a brief 1-minute intro video along with your application. Please share a Google drive link for your video. Thanks!