[Hiring] Insurance AR Specialist @ORTHOLONESTAR MSO LLC

Role Description

Responsible for reviewing and submitting claims on a daily basis.

Essential Duties and Responsibilities

• Prepares and submits clean claims to various insurance companies either electronically or on paper.
• Contacts carriers by phone or website for claim status on outstanding insurance balances.
• Processes and works all insurance correspondence.
• Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to other carriers.
• Obtains necessary documentation required to submit to insurance to expedite payments.
• Answers questions from patients, clerical staff, and insurance companies.
• Identifies and resolves patient billing complaints.
• Prepares appeal letters for all claims that are denied for payment.
• Documents all collection activities using guidelines in place.
• Identifies underpayments by checking payments received against our contracted fee schedule.
• Works and processes all insurance refund requests.
• Reports payer issues or delays to supervisor.
• Participates in educational activities.
• Maintains strict confidentiality; adheres to all HIPAA guidelines/regulations.
• Team player with ability to solve problems and recommend solutions.
• Must be able to manage assigned workload and prioritize accordingly.
• Maintains accurate and timely reconciliation of accounts receivable.
• Reviews claims stopped in the claim scrubber.
• Works claims rejected by the clearinghouse.

Qualifications

• High School Diploma or GED, and minimum one year experience in a medical billing/collections field.
• Ability to write and read.
• Ability to add, subtract, multiply, and divide on all units of measure, using whole numbers, common fractions, and decimals.
• Ability to read and interpret explanation of benefits remittances to determine and identify claim denial reasons and necessary course of action for resolutions.
• Ability to type 45 WPM, basic proficiency in Microsoft Outlook/Office, and experience using or ability to learn and comprehend computer programs.
• No certificates or licenses required.
• Position works in a climate-controlled office environment in a cubicle setting.

Physical Demands

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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.