AR Specialist

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

📋 Description

• Analyze and investigate claims denials, reaching out to payers to confirm specific denial reasons when needed.

• Reach out to patients to gather precise insurance information.

• Compile documentation and submit reconsiderations and appeals as necessary.

• Recognize and report denial/rejection patterns to management.

• Detect and resolve discrepancies.

• Explore and review insurance policies and benefits to identify policy exclusions.

• Investigate and analyze payer medical reimbursement policies and exclusions.

• Review and manage daily correspondence from patients and payers.

• Comprehend and act in accordance with timely filing guidelines related to claims filing, reconsiderations, and appeals for designated payers.

• Assess accounts for accuracy, including payments and adjustments.

• Manage medical EOBs, patient deductibles and copays, along with insurance or third-party correspondence.

• Utilize payer websites effectively.

• Handle aged AR EDI transactions and troubleshoot any issues.

• Execute other assigned responsibilities.

⛳️ Requirements

• Experience with eClinicalWorks is preferred.

• HST experience is highly preferred.

• A minimum of 2-4 years of experience in medical billing, collections, and/or payment posting.

• High school diploma or GED is required.

• Strong time management and organizational abilities.

• Proficiency in computer usage.

• Capability to prioritize tasks effectively.

• Accurate and proficient in 10 Key entry.

• Ability to work independently and adjust to a fast-paced environment.

• Knowledge of Medicare, Medicaid, Medicaid MCOs, and commercial insurance.

• Excellent problem-solving and critical thinking skills.

• Strong interpersonal and communication abilities.

• Familiarity with ICD-10/CPT coding.

• Compliance with all HIPAA guidelines and regulations.

🏝️ Benefits

• Fully remote work arrangement.