AR Specialist 2

This is a fully remote position, open to applicants in United States.

📋 Description

• Verify and obtain eligibility and/or authorization via payer websites, client eligibility systems, or phone communications.

• Update patient demographics and insurance details in the appropriate systems.

• Investigate and track unpaid or denied claims.

• Monitor claims for any missing information, authorization, and control numbers (ICN/DCN).

• Examine EOBs for payments or adjustments to resolve claims effectively.

• Communicate with payers through phone or written correspondence to obtain claim payments.

• Access client systems for payment, patient, claim, and data information.

• Adhere to prioritization, timely filing deadlines, and notation protocols.

• Secure medical documentation as requested by third-party insurance carriers.

• Ensure patient information confidentiality in accordance with insurance collection guidelines and corporate policies.

• Utilize provider billing manuals to gather billing guidelines and requirements.

• Draft appeal letters for technical appeals.

• Verify the accuracy of underpayments using contracts and claims data.

• Prepare claims for clinical audit processing concerning authorization, coding, level-of-care, or length-of-stay denials.

• Perform additional related duties as needed.

• Act as a liaison to clinical auditors, team members, hospital staff, government agencies, and health plans to ensure prompt claim payment.

⛳️ Requirements

• A minimum of 2 years of experience in medical collections/billing.

• Intermediate knowledge of ICD-10, CPT, HCPCS, and NCCI.

• Intermediate understanding of third-party billing guidelines.

• Intermediate familiarity with billing claim forms (UB04/1500).

• Intermediate knowledge of payor contracts.

• Proficient in Microsoft Word and Excel.

• Intermediate working knowledge of health information systems (e.g., EMR, Claim Scrubbers, Patient Accounting Systems, etc.).

• Experience with one or more patient accounting systems such as EPIC or Cerner is preferred.

• Familiarity with the DDE Medicare claim system is preferred.

• Knowledge of government rules and regulations is preferred.

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health, dental, and vision insurance.

• 401(k) plan with company matching.

• Opportunities for professional development and career advancement.

• Flexible work schedule and remote work options.