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