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Insurance AR Specialist (2247)

Role overview

Responsibilities

  • Prepares and submit clean claims to various insurance companies either electronically or on paper.
  • Contact carriers by phone or website for claim status on outstanding insurance balances.
  • Process and work all insurance correspondence.
  • Perform various collection actions including contacting patients by phone, correct and resubmitting claims to other carriers.

Key facts

Hard skills

Other skills

  • Communication
  • Problem Solving
  • Teamwork
  • Time Management

About the company

OrthoLoneStar logo

OrthoLoneStar

  • Medical Practices & Clinics
  • 1,001–5,000
Quality focused, physician led healthcare. Proud to be the largest independent orthopedic practice serving Texas. Our divisions include Advanced Orthopaedics & Sports Medicine, Azalea Orthopedics, Fondren Orthopedic Group, Texas Orthopedics Sports & Rehabilitation Associates, Texas Orthopaedic Associates, and Carrell Clinic. We currently serve Dallas, Houston, Austin, Frisco, Fort Worth, Plano, Baytown, Clear Lake, Pearland, Athens, Jacksonville, Longview, Mount Pleasant, Nacogdoches, Palestine, Pittsburg, Tyler, Cypress, Houston, Spring, Tomball, Bastrop, Cedar Park, Kyle, Lakeway, Marble Falls and Round Rock.

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Job description

Job Summary:  Responsible for reviewing and submitting claims on a daily basis. 

Essential Duties and Responsibilities: The essential duties of the position include the following. Other duties may be assigned.

Key Functions:

  • Prepares and submit clean claims to various insurance companies either electronically or on paper.
  • Contact carriers by phone or website for claim status on outstanding insurance balances.
  • Process and work all insurance correspondence.
  • Perform various collection actions including contacting patients by phone, correct and resubmitting claims to other carriers.
  • Obtain necessary documentation required to submit to insurance to expedite payments.
  • Answers questions from patients, clerical staff and insurance companies.
  • Identify and resolve patient billing complaints.
  • Prepare appeal letters for all claims that are denied for payment.
  • Document all collection activities using guidelines in place.
  • Identify underpayments by checking payments received against our contracted fee schedule.
  • Work and process all insurance refund requests.
  • Report payer issues or delays to supervisor.
  • Participate in educational activities
  • Maintains strict confidentiality; adhere to all HIPAA guidelines/regulations.
  • Team Player with ability to solve problems and recommend solutions.
  • Must be able to manage assigned workload and prioritize accordingly.
  • Maintain accurate and timely reconciliation of accounts receivable.
  • Review claims stopped in the claim scrubber.
  • Work Claims rejected by the clearinghouse.

Supervisory Responsibilities: None.

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