Insurance AR Specialist

About the Company

American Vision Partners (AVP) partners with the most respected ophthalmology practices in the country and integrates best-in-class management systems, operational infrastructure, and advanced technology to provide the highest quality patient care possible. Our practices include Barnet Dulaney Perkins Eye Center, Southwestern Eye Center, Retinal Consultants of Arizona, M&M Eye Institute, Abrams Eye Institute, Southwest Eye Institute, Aiello Eye Institute, Moretsky Cassidy Vision Correction, Wellish Vision Institute, West Texas Eye Associates, and Vantage Eye Center. We operate more than 100 eye care centers in Arizona, New Mexico, Nevada, California, and Texas—including 25 ambulatory surgical centers. AVP values teamwork, exceptional experiences, continuous improvement, financial strength, and hard work, and is committed to providing best-in-class patient care, pioneering research and technology, and rewarding and recognizing employees.

About the Role

This position collects payments for an assigned segment of the insurance accounts receivable and performs collection duties in accordance with established federal and state regulations.

Responsibilities

• Follows up with insurance companies and ensures claims are paid/processed, with understanding of all applicable insurance and/or CMS regulations.
• Resubmits insurance claims that have received no response or are not on file, in a timely manner according to each insurance’s contracted filing limits.
• Reviews and appeals unpaid and denied claims as appropriate, including analysis of coding, insurance eligibility, and contract requirements to ensure proper billing.
• Makes changes to demographic and insurance information as necessary to produce a clean claim.
• Researches and prepares insurance credits for refund approval.
• Prioritizes work to maximize turn-around time.
• Meets or exceeds productivity standards in the completion of daily assignments and accurate production.
• Maintains an error rate in accordance with departmental policy.
• Answers and responds to external and internal phone calls in a timely and professional manner.
• Checks and responds to emails in a timely and professional manner.
• Performs all other assigned duties.
• Conducts self in accordance with the company’s standard values and policies.
• Participates in educational programs to maintain current skill and competency levels.

Supervision

Monthly meetings with supervisor. Informal supervision through an open-door policy. Employees are expected to ask questions when needed.

Requirements

• High School diploma or equivalent.
• 2 years of medical billing or healthcare insurance follow-up experience.

Skills and Proficiencies

• Active knowledge of CMS guidelines, contracted insurance guidelines, and coding policies.
• Demonstrated computer literacy.
• Well-organized with attention to detail.
• Ability to read and understand oral and written instructions.
• Excellent math skills.
• Ability to establish and maintain effective working relationships with team members, clinic staff, payers, and patients.
• Excellent professional customer service skills.
• Desire and dedication to work with self-discipline.
• Maintains strictest confidentiality and adheres to all HIPAA guidelines and regulations.

Physical Abilities

• Ability to sit for long periods.
• Work requires walking, bending, standing, sitting, and reaching.

Benefits

• Medical and dental insurance.
• Significant eye care discounts.
• Child care assistance.
• Pet insurance.
• Continuing education funds.
• 401(k).
• Paid holidays.
• Paid time off (PTO).
• Sick time.
• Opportunities for growth.