[Hiring] Insurance AR Specialist @ORTHOLONESTAR

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.
• Contact carriers by phone or website for claim status on outstanding insurance balances.
• Process and work all insurance correspondence.
• Perform various collection actions including contacting patients by phone, correcting and resubmitting claims to other carriers.
• Obtain necessary documentation required to submit to insurance to expedite payments.
• Answers questions from patients, clerical staff, and insurance companies.
• Identify and resolve patient billing complaints.
• Prepare appeal letters for all claims that are denied for payment.
• Document all collection activities using guidelines in place.
• Identify underpayments by checking payments received against our contracted fee schedule.
• Work and process all insurance refund requests.
• Report payer issues or delays to supervisor.
• Participate in educational activities.
• Maintains strict confidentiality; adhere 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.
• Maintain accurate and timely reconciliation of accounts receivable.
• Review claims stopped in the claim scrubber.
• Work 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.
• None.
• 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.