Medical Billing AR / Denials Specialist

Company Overview: Summit Spine and Joint Centers (SSJC) is a rapidly growing, multi-state Interventional Pain Management practice providing comprehensive clinical, surgical, and imaging services. With locations across Georgia, North Carolina, South Carolina, Tennessee, Florida, and Texas, our team is committed to delivering exceptional, patient-centered care through collaboration, innovation, and clinical excellence. As one of the largest single-specialty pain management practices in the nation, SSJC continues to expand its network while investing in the people who make our success possible. We are seeking motivated, qualified professionals who are passionate about making a meaningful impact and contributing to our continued growth. Job Duties: Processes assigned AR, working to maximize collections while minimizing aging AR Process insurance denials and appeals to ensure timely account resolution Identify denial trends and provide management with a summary of identified issues Manages outstanding accounts to include following up with insurance carriers for overpayments, underpayments, filing corrected claims, appealing claims, and following up on all denials to ensure processing / reprocessing and timely payments Review AR aging to ensure timely collection of payments Review and initiate payor and patient refunds Appropriately documents issues, sources, and actions taken on each account Identify, document, and report payer denial trends to billing manager for escalated follow-up Creates reports regarding the status of patient accounts as requested Address inquiries from insurance companies, patients, and providers Ensure claim information is complete and accurate Post office paper zero pay denials, and scan into our system Verify patient benefits and eligibility Maintain denials productivity spreadsheet Follows HIPAA guidelines in handling patient information Qualifications: Minimum of 3 years’ experience with accounts receivable or revenue cycle in a medical setting Experience with Medicare, Medicaid, Commercial insurance plans, Workers’ comp, and Personal Injury cases Knowledge of claims submission of office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management Knowledge of medical billing rules, such as coordination of benefits, modifiers, and understanding of EOBs and ANSI code denials. Excellent knowledge of CPT coding, ICD.10 coding and medical pre-certification protocols required Excellent computer skills and familiarity with Microsoft Office Comfortable working in a growing, dynamic organization and able to navigate change. Self-motivated with ability to multi-task, prioritize work in a fast-paced, team environment Bachelor’s degree preferred Experience using eClinicalWorks preferred Experience with Pain Management preferred Preferred Location While this is a remote position, preference will be given to candidates residing in one of the following states: Georgia Texas North Carolina South Carolina Florida Candidates located in Georgia should be able to attend meetings or training at our Lawrenceville administrative office as needed. Compensation & Benefits This is a full-time position offering a competitive salary, paid time off (PTO), comprehensive health benefits, and a 401(k) with company match.