SpineOne, PLLC Hiring for AR Billing Specialist at Remote Full Time

Job purpose

The AR Billing Specialist is responsible for full Revenue Cycle duties which include assisting with clean claim submission, verify contractual payment is received, appealing insurance denials, answering patient phone calls, reviewing patient statements, working all outstanding claims and all AR related items, and assisting with special projects.

Duties and responsibilities

• Investigate and analyze claim denials to determine the root cause and develop effective strategies to prevent future denials.
• Develop and maintain a thorough understanding of payer-specific policies and guidelines to effectively appeal denied claims in a timely and accurate manner.
• Utilize the EHR and other revenue cycle management software to monitor and track the claim submission process, ensuring timely filing and accurate payment.
• Assists with uploading patient accounts with an outstanding balance to collection agency when all efforts of collection are exhausted.
• Collaborate with other departments to identify and address any system issues that may lead to rejected claims in the EHR system.
• Monitors accounts to ensure timely payments and investigates any discrepancies or billing errors.
• Review and research refund requests from insurance and appeal based on developed payer-specific guidelines.
• Responsible for correcting and rebilling all rejected claims in clearinghouse within AR assignment.
• Can comfortably work with all customer types via phone and email.
• Collaborates with internal departments to resolve billing issues and answer customer inquiries.
• Assist with payment posting tasks, ensuring accurate and timely payment application.
• Maintain accurate records of all customer interactions and transactions, including detailed billing notes on any billing issues or concerns.
• Communicate effectively and professionally with all customers, including patients, families, and internal and external stakeholders.
• Proactively diffuse and resolve conflicts by communicating with all parties involved in a respectful and professional manner.
• Ensure compliance with all established policies and procedures.
• Can successfully manage mail and fax correspondences.
• Performs all other duties as assigned by supervisor.

Education and Experience Requirements

• GED/High School Diploma
• Medical billing/coding certificate or equivalent is preferred.
• 3+ years’ experience in the medical billing field is preferred.
• Previous experience in a physician’s office is desired.
• Knowledge of medical terminology is preferred.
• Computer and office equipment skills required.

Knowledge, skills, and abilities required.

• Ability to work within a team and independently.
• Ability to handle confidential information.
• Ability to handle multiple tasks.
• Ability to use a computer, multi-line phone system, and other office machines.
• Ability to use discretion in dealing with the public.
• Excellent professional, organizational, and communication skills.
• Strong interpersonal skills.

Job Expectations

• Can interpret payments postings and account adjustments and decipher when an appeal is necessary.
• Follow up on all rejections and denials within a 72-hour period.
• Manage accounts receivable and review AR weekly to ensure insurance A/R does not exceed 180 days.
• Ability to handle multiple tasks.
• Strong interpersonal skills.
• Effective time management.
• Maintains professional dress and appearance.
• Maintains work area and equipment in a clean and professional manner.
• Displays a caring and responsive attitude and conducts all activities respecting patient, family and employee rights and expectations.
• Diffuses/resolves conflict by appropriately communicating with those involved.

Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is occasionally required to stand, walk, sit, use hands to touch, handle, or feel objects, tools, or controls, reach with hands and arms, climb stairs, balance, stoop, kneel, crouch or crawl, talk and listen. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.

Environmental Conditions

The job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.