AR Specialist

Duties/Responsibilities include but are not limited to:

•  Effectively review and research claims denials and contact payers to verify detailed denial reasons when necessary
•  Contact patients to obtain accurate insurance information.
•  Prepare documentation and file reconsiderations and appeals as appropriate.
•  Able to identify and communicate denial/rejection trends to management
•  Able to identify and resolve discrepancies
•  Navigate and research insurance policies & benefits for policy exclusions for patients.
•  Navigate and research payer medical reimbursement policies and exclusions.
•  Review and work all daily correspondence received from patients and payers.
•  Understand and act on the timely filing guidelines associated with claims filing, reconsiderations, and appeals for assigned payers.
•  Review accounts for accuracy (payments and adjustments)
•  Knowledge of medical EOB’s, patient deductibles and co pays, and insurance or third-party correspondence
•  Experience working with payer websites
•  Experience in working aged AR
•  EDI transactions/troubleshooting
•  Other assigned duties

Applicants must have:

•  eClinicalWorks experience is preferred
• HST experience is strongly preferred
•  Minimum of 2-4 years of medical billing, collections, and/or payment posting experience
•  High school diploma or GED
•  Candidate must exhibit excellent time management, organizational skills, and be computer literate.
•  Ability to prioritize workload
•  10 Key – accuracy and proficiency
•  Ability to work independently and adapt to a fast-changing environment
•  Knowledge of Medicare, Medicaid, Medicaid MCO’s, and commercial insurance.
•  Strong problem-solving and critical thinking skills
•  Strong interpersonal and communications skills
•  Must have ICD-10/CPT knowledge
•  Adhere to all HIPAA guidelines/regulations