AR Specialist

Summary

Responsible for a variety of medical office /clerical tasks relating to claims processing; contacts patients and responsible parties to resolve past-due accounts; investigates account status and initiates collection procedures. 

Essential Duties and Responsibilities 

• Timely and appropriate resolution of all assigned accounts for third-party payors and/or patients with the purpose of managing accounts receivable balances.
• Identify and communicate AR trends, denial issues, or irregularities impacting the resolution of AR or daily production workflow to the supervisor and other team members and recommend resolution.
• Responsible for accurate and timely charge capture for clinic and hospital-based services. 
• Maintains up-to-date knowledge of third-party billing and reimbursement, the clinic’s financial policies, and industry knowledge. 
• Prepares and submits daily productive reports as required. 
• Completes annual compliance and regulatory requirements as applicable.

Supervisory Responsibilities 

This job has no supervisory responsibilities.

Competencies 

• Analytical - Synthesizes complex or diverse information; collects and researches data; uses intuition and experience to complement data.
• Continuous Learning - Seeks feedback to improve performance; pursues training and development opportunities; shares expertise with others.
• Job Knowledge - Competent in required job skills and knowledge; exhibits ability to learn and apply new skills; keeps abreast of current developments; requires minimal supervision; displays understanding of how the job relates to others; uses resources effectively.
• Use of Technology - Demonstrates required skills; adapts to new technologies; troubleshoots technological problems; uses technology to increase productivity; keeps technical skills up to date.
• Problem Solving - Identifies and resolves problems in a timely manner; gathers and analyzes information skillfully; develops alternative solutions; works well in group problem-solving situations; uses reason even when dealing with emotional topics.
• Customer Service - Manages difficult or emotional customer situations; responds promptly to customer needs; solicits customer feedback to improve service; responds to requests for service and assistance; meets commitments.
• Communications - Expresses ideas and thoughts verbally; expresses ideas and thoughts in written form; exhibits good listening and comprehension; keeps others adequately informed; selects and uses appropriate communication methods.
• Cooperation - Establishes and maintains effective relations; exhibits tact and consideration; offers assistance and support to co-workers; works cooperatively in group situations; works actively to resolve conflicts.
• Managing Customer Focus - Promotes customer focus; establishes customer service standards; provides training in customer service delivery; monitors customer satisfaction; develops new approaches to meeting customer needs.
• Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions; demonstrates group presentation skills; participates in meetings.
• Teamwork - Balances team and individual responsibilities; exhibits objectivity and openness to others' views; gives and welcomes feedback; contributes to building a positive team spirit; puts the success of the team above own interests.
• Written Communication - Writes clearly and informatively.
• Conflict Resolution - Encourages open communications; maintains objectivity.
• Diversity - Shows respect and sensitivity for cultural differences.
• Ethics - Treats people with respect; works with integrity and principles; upholds organizational values.
• Organizational Support - Follows policies and procedures; completes administrative tasks correctly and on time.
• Adaptability - Adapts to changes in the work environment; manages competing demands; changes approach or method to best fit the situation; able to deal with frequent change, delays, or unexpected events.
• Consultative Selling - Builds rapport and establishes trust.
• Achievement Focus - Measures self against the standard of excellence.
• Personal Appearance - Dresses appropriately for position; keeps self well-groomed.
• Attendance/Punctuality - Is consistently at work and on time; ensures work responsibilities are covered when absent; arrives at meetings and appointments on time.
• Dependability - Follows instructions, responds to management direction; takes responsibility for own actions; commits to long hours of work when necessary to reach goals.; completes tasks on time or notifies the appropriate person with an alternate plan.
• Initiative - Seeks increased responsibilities; asks for and offers help when needed.
• Innovation - Displays original thinking and creativity; meets challenges with resourcefulness; generates suggestions for improving work.
• Judgment - Exhibits sound and accurate judgment; makes timely decisions.
• Quality - Demonstrates accuracy and thoroughness; monitors own work to ensure quality.
• Quantity - Meets productivity standards; completes work in a timely manner; strives to increase productivity; works quickly.
• Safety and Security - Observes safety and security procedures; reports potentially unsafe conditions; uses equipment and materials properly.

Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience 

• High school diploma or general education degree (GED).  Minimum 5 years of medical billing and account follow-up experience. Certified Patient Account Representative (CPAR) preferred.
• Knowledge of ICD-10, CPT, HCPCS, and the use of modifiers preferred. Familiar with CMS 1500/UB04 claim form completion, knowledge of Medicare, Managed care, and commercial insurance products and plans.
  
• Knowledge of physician billing and /or collections. Typing speed 55 wpm and the ability to use a calculator.

Language Skills 

• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.  Ability to write routine reports and correspondence.  Ability to speak effectively before groups of customers or employees of the organization.

Mathematical Skills 

• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent, and to draw and interpret bar graphs.

Reasoning Ability 

• Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions.  Ability to deal with problems involving a few concrete variables in standardized situations.

Computer Skills 

• To perform this job successfully, an individual should be proficient in MS Word, Excel, and PowerPoint.  General knowledge of technology is preferred.

Certificates, Licenses, Registrations 

• CPC required

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. While performing the duties of this Job, the employee is regularly required to sit; use hands to handle or feel; reach with hands and arms; and talk or hear.  The employee is occasionally required to stand, walk, stoop, kneel, crouch, or crawl. These duties could require the ability to lift files, open file cabinets, and bend or stand as necessary. The employee must occasionally lift and/or move up to 30 pounds.  The employee will operate a keyboard, calculator, telephone, copy machine, computer, and other office equipment as necessary. Specific vision abilities required by this job include close vision. It is necessary to view and type on computer screens for long periods of time and to work in an environment that can be very stressful. 

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Must be able to deal with aggressive, hostile, and sometimes irrational behavior of patients and family members and have the ability to respond to all patients in a calm and professional manner. 

 Peachtree Orthopedics is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.