Remote AR Specialist - Medical Billing

Day in the Life of an AR Specialist

• Performs all duties and responsibilities in accordance with local, state, and federal regulations and company policies.
• Utilizes and applies industry knowledge to resolve new and aged accounts receivables by working various account types, including but not limited to professional claims, governmental and/or non-governmental claims, denied claims, aged accounts, high priority accounts, high dollar accounts, reimbursements, credits, etc.
• Leverages available resources and systems (both internal and external) to analyze patient accounting information and take appropriate action for payment resolutions, documenting all activity in accordance with organizational and client policies.
• Communicates professionally (in all forms) with payer resources, including websites/payer portals, email, telephone, customer service departments, etc.
• Maintains quality and productivity results at a level that meets departmental standards as measured by a daily/weekly/monthly average.
• Reviews claims data and supporting documentation to identify coding and/or billing concerns.
• Interprets payer contracts and identifies contract variances affecting reimbursement.
• Utilizes knowledge of the cash posting processing to obtain the necessary information to resolve misapplied payments.
• Demonstrates clear proficiency in third-party billing requirements, including federal, state, and commercial/managed care payers.
• Interprets claim scrubber edits/rejections and takes appropriate action necessary to resolve issues.
• Sets up and tracks appeals for technical denials by accessing specific payer appeal forms, submitting appropriate medical documentation, and tracking appeal resolution.
• Analyzes accounts with critical thinking, considering payer contracts and billing guidelines to ensure one-touch resolution.
• Identifies denials trends, root cause, and A/R impact.
• Serves as a resource to other team members and assists Team Leads with identifying A/R and denials trends.
• Further responsibilities may include reviewing insurance credit balances to determine root cause and taking the steps necessary to resolve the account.

Education And Experience Requirements

• Must have had at least 2 years accounts receivable experience in a physician office setting.
• General Knowledge of HCPCS, CPT-4 and ICD-10 coding and/or medical terminology.
• Familiar with multiple payer requirements and regulations for claims processing.
• Must have a High School Diploma/GED.

Position Benefits

• Daily impact on many lives.
• Excellent training if you are new to this field.
• Mileage reimbursement (if applicable).
• Community events promoting belonging and education, such as community cook outs, various fairs related to addiction treatment and outreach, parades, addiction awareness for schools, and holiday events.
• Opportunity to save lives every day!
• Benefits Package:
• Medical, Dental, and Vision Insurance.
• PPO.
• Variety of 401K options including a match program with no vesture period.
• Annual Continuing Education Allowance (in related field).
• Life Insurance.
• Short/Long Term Disability.
• Paid maternity/paternity leave.
• Calm subscription for all employees.