AR Claims Specialist II

Position Highlights

1.0 FTE (40 hours per week)

$21.44-$26.27/hour DOE with the ability to go higher for highly experienced candidates

100% employer-paid health insurance, including medical, dental, vision, Rx, 24/7 telemedicine

Profit sharing & 403(b) retirement plan available

Generous PTO, 8 paid holidays, and much more!

What You’ll Do

• Process third-party claims in a timely and accurate manner, resolving claim edits and resubmitting corrected claims as necessary
• Provide required documentation in account notes and participate in developing standard texts for account documentation
• Maintain Epic Claims work queues according to daily department standards and research causes of repeated errors, addressing solutions through feedback loop processes
• Reconcile daily claim volume balances using information from Epic and claims clearinghouse reports
• Actively works with intra-department leadership to create compliant, automated processes within Epic and the claims clearinghouse
• Actively stay abreast of all payor billing changes and requirements, becoming the subject-matter expert for assigned payors
• Maintain daily balance logs of claims sent from the EMR to the clearinghouse to ensure all claim runs are balanced daily
• Train new AR Claims staff when called upon
• Uphold Medicare, Medicaid, and HIPAA compliance guidelines in relation to billing, collections, and PHI information
• Participate in the development of claims education and procedure documentation
• Maintain confidentiality of all patient demographic, medical, and financial information at all times
• Perform other duties as assigned

Qualifications

• High School diploma or GED
• 3 years of previous medical billing with third party and Medicare/Medicaid experience required
• Certified Revenue Cycle Representative (CRCR) certification required
• Completion of HFMA courses Strategies to Prevent Claim Denials or Best Practice (Patient Centric) Revenue Cycle Overview within 180 days of hire
• Experience with EPIC system and FQHC billing and/or coding preferred
• Strong attention to detail, analytical skills, and ability to meet deadlines
• Knowledge of medical and insurance terminology, CPT, ICD coding structures, and billing forms (UB, 1500)
• Strong customer relations skills preferred
• Knowledge of medical/dental terminology, data entry, and billing coding preferred
• Knowledge of accounts receivable processes preferred
• Maintain consistent performance and attendance standards
• Strong written and verbal communication skills