AR Specialist

Job Summary

The AR Specialist is an essential part of the TOA Central Business Office. As an AR Specialist, you will use your analytical, financial, and customer service skills to ensure that TOA claims filed to an insurance payer are processed accurately and in a timely manner.

Responsibilities

• Promptly identify any errors or other issues in claims processing.
• Effectively following up on any unpaid balances.
• Expeditiously bring any remaining balance to resolution.
• Meet quality assurance and productivity standards by identifying and reconciling insurance balance accounts.
• Identify denial trends and provide potential solutions while analyzing patient accounts utilizing our EPM system - Nextgen to determine appropriate action.
• Review explanations of benefits details on denials.
• Communicate with insurance payer representatives, patients, and TOA staff to ensure timely and accurate resolution of account transactions. This would include Commercial plans, Medicare/Medicare HMO plans, Medicaid/Medicaid HMO plans, and BCBSTN.
• Prioritize assigned accounts to maximize aged accounts receivable resolution.
• Review the explanation of benefit (EOB) documentation and notate accounts on collection activity to perform account resolution.
• Operate within established guidelines and protocols, including providing backup documentation for our accounting and audit functions.
• Collaborate closely with the Central Business Office, clinical colleagues, and administrative teammates to develop a cohesive, high-performing team.
• Adhere to HIPAA and OSHA safety guidelines.

Requirements

• MUST reside and work in either the Middle TN, Knoxville TN, or the Columbia TN area.
• Exceptional customer service and patient focus.
• Knowledge of Insurance - particularly coordination of benefit rules and denial overturns are essential to this position.
• Knowledge of administrative and clerical procedures.
• Accustomed to using mostly payer websites for appeals/reconsiderations, medical records attachments, verification of benefits, and/or web-based claims follow-up.
• Ability to communicate and work as a team.
• Demonstrated proficiency with Microsoft Office programs such as Excel, Word, and Outlook.
• At least 3 years insurance collections experience.
• Experience using NextGen.
• Orthopaedic specialty experience.
• Fluency in English is required; Fluency in a second language is a plus.

Working Conditions

TOA fosters an excellent working environment of positivity, collaboration, job satisfaction, and engagement. The department experiences high volume, and as a result, it has associated stressors that conflict with a fast-paced environment. Regularly sit while working on the computer; use hands and fingers to handle, control, or feel objects, tools commands; repeat the same movements when entering data; speak clearly so listeners can understand; understand the speech of another person; ability to differentiate between colors, shades, and brightness; read from a computer screen for extended periods time.