Accounts Research Specialist - TMG Billing (Days)

About the role

Responsible for day-to-day follow-up of Medicare, Medicare Advantage plans, Medicaid, CMOs, and commercial insurance claims, and the review of aging reports to identify and resolve problem areas. Includes working all rejections and denials accurately and efficiently. Requires prioritizing work, formulating a plan of action, analyzing results, and communicating trends and billing coding issues.

Responsibilities

• Follow up on Medicare, Medicare Advantage, Medicaid, CMOs, and commercial insurance claims
• Review aging reports to identify and resolve problem areas
• Work rejections and denials accurately and efficiently
• Prioritize workload and formulate action plans
• Analyze results and communicate trends and billing coding issues
• Resolve claim denials timely to maintain AR days and greater than 90-day AR categories below MGMA standards

Requirements

• High School Diploma or GED
• Two years of related experience
• Working knowledge of specialized practices, equipment, and procedures
• Minimum of two years experience in insurance and patient billing, accounts receivable (AR), including credits, refunds, offsets, and posting payments
• Comprehension of working and analyzing AR to resolve claim denials
• Working knowledge of CPT & ICD Coding and medical terminology

Skills

• Meticulous organization, analysis, and prioritization of workload
• Strong verbal and written communication skills
• Ability to communicate issues to management and propose resolutions
• Professional teamwork and collaboration
• Perform responsibilities with integrity