Job Summary:
The Medical Billing AR Specialist is responsible for managing the accounts receivable process within the medical billing department. This includes following up on unpaid claims, resolving denials, and ensuring timely reimbursement from insurance companies and patients. The role requires strong attention to detail, excellent communication skills, and a deep understanding of medical billing procedures and regulations.

Responsibilities:

• Review and analyze unpaid claims to identify reasons for non-payment or denial.
• Investigating and resolving billing discrepancies and unpaid claims
• Verifying insurance coverage and eligibility for patients
• Investigate and appeal denied claims as necessary, ensuring maximum reimbursement.
• Processing patient payments and reconciling accounts receivable
• Communicating effectively with patients, insurance companies, and internal staff regarding billing and payment inquiries
• Staying current with insurance regulations and billing guidelines
• Determining an account's ability to pay
• Coordinating duplicate billings
• Identifying trends in payer non-compliance
• Processing insurance denials and appeals
• Identifying denial trends and determining process changes to prevent future denials
• Assisting with or obtaining pre-authorization as required by various carriers
• Working with other teams to address editing, coding, and payment related issues
• Reviewing and analyzing health care provider claims
• Identifying trends and issues within the revenue cycle process
• Assist with other duties as assigned by management

Requirements:

• High school diploma or equivalent; additional education in medical billing or related field preferred.
• Proven experience in medical billing and accounts receivable management.
• Proficiency with medical billing software and electronic health record (EHR) systems. ECW and Way-star experience preferred.
• Strong understanding of medical coding, billing codes (CPT, ICD-10, HCPCS), and insurance claims processing.
• Excellent communication and interpersonal skills.
• Ability to work independently and as part of a team in a fast-paced environment.
• Detail-oriented with strong analytical and problem-solving abilities.
• Knowledge of healthcare regulations, including HIPAA compliance.
• Prior experience with Medicare, Medicaid, and commercial insurance billing.

This is not a 100% work from home position. You will be required to come in for a monthly department meeting and you may need to come in for additional training.

Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Work setting:

• Hybrid work

Application Question(s):

• What is your desired compensation?
• Can you train in the Elizabeth location for 2 weeks?
• Can you come to the Elizabeth location for monthly meetings and additional training when needed?

Experience:

• ICD-10: 1 year (Preferred)

Work Location: Hybrid remote in Elizabeth, NJ 07208