Description

JOB TITLE: AR Insurance Collections Specialist 

REPORTS TO: Finance Director 

STATUS: Non-Exempt 

JOB OVERVIEW: Performs accounting and billing functions to support the processing of medical claims for our physician services. Each person is assigned a designated physician and is responsible for ensuring the billing process is maintained within departmental standards. Position requires regular, effective communication with other staff, patients, and insurance representatives. Must be organized and effective with multi-tasking. 

DUTIES AND RESPONSIBILITIES: • Works closely with guarantors and patients to secure reimbursement on outstanding account balances. You will spend 90% of the day on the phone and/or insurance websites. • Reviews medical claims for accuracy, including charges entered by physicians complying with the medical documentation and CPT coding. • Appeal as needed for disputed/denied claims. Consults Management & Team Lead when necessary to work out difficult codes and/or other billing related issues. • Ensures that all processing and reporting deadlines are consistently achieved. Maintains productivity levels set forth by practice guidelines. • Working knowledge of managed care contracts, fee schedules, ICD-10, CPT coding and a strong knowledge of medical terminology. • Perform appropriate follow-up actions on claims such as re-billing of primary, secondary, and tertiary claims. Update records to include notes on accounts and maintain aging balances in accordance with acceptable collection standard.

Requirements

QUALIFICATIONS: • High school diploma or GED equivalent • A minimum of 2 years collection experience in healthcare revenue is preferred. • Auditing skills for coding quality & compliance and an understanding of guidelines. • Demonstrate excellent written and verbal communication skills. • Must have a working knowledge of Microsoft Word and Excel. • Must be comfortable learning and using computers along with multiple medical billing applications. • Must be organized with a strong attention to detail. • Outstanding customer service skills 

Physical abilities: • Sit for extended periods of time; push, pull and reach; occasionally bend, sit, stoop and stretch • Have full range of body motion • Have the hand-eye coordination and manual dexterity needed to operate a keyboard, photocopier, telephone, calculation • Have a normal range of hearing and eyesight to record, prepare and communicate appropriately • Occasionally lift and carry up to 20 pounds

Note: The physical demands described here are representative of those that must be met by an employee to successfully perform essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this job. The intent of this job description is to provide a representation of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.