Medical AR Follow-Up Specialist

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Maintaining AR queues at a reasonable age-base date as defined by management
• Timely submission of medical record documentation requests from payers
• Responsible for reviewing and resolving denied or aging medical claims
• Responsible for timely follow-up on all appeal submissions
• Escalate exhausted appeal efforts, denials, and/or overpayment trends, as needed to Billing Manager for resolution or escalation
• Work payer projects as directed

KNOWLEDGE, SKILLS, ABILITIES

• Solid understanding of payer specific billing and claims submission policies, including timely filing limits, medical record, corrected claim, and reconsideration submission
• Advanced business letter writing skills to include correct use of grammar and punctuation required for appeal letter writing and submission
• Working knowledge of professional and institutional claim forms (CMS-1500, UB-04)
• Basic understanding of ICD-10 CM, CPT, Modifier and HCPCS codes, and medical terminology
• Proficient Microsoft Office (Outlook, Word, Excel, and Teams) skills

EDUCATION / EXPERIENCE

• High School Diploma or equivalent, college coursework preferred
• 1 – 3 years’ experience in a healthcare environment performing billing and/or collections or equivalent revenue cycle experience
• Enterprise eClinical Works E HR experience preferred
• Prior experience and knowledge of Orthopedic, Physical Therapy, Occupational Therapy, and Workers Compensation billing is beneficial

WE OFFER

• Medical Insurance, Dental, & Vision
• Health Savings Account
• Flex Spending for child care
• Paid life insurance of $50,000
• Paid Long Term Disability Insurance
• Voluntary Life Insurance
• Voluntary Short Term Disability
• Many Aflac Policies: Accident, Hospital, Critical Illness, Identity Theft, Legal Plan
• 401K – very generous plan… the company contributes even if you do not
• PTO (Paid Time Off) – generous plan
• Employee Perks