Job Title: Medical A/R Specialist
The AR specialist will generally act as an intermediary between our patients and their health insurance carrier. You must maintain a high level of professionalism and adhere to all debt collection rules and regulations.
You will handle billing and collections, claim denials, claim appeals, patient accounts, and various administrative duties. All debt-related matters will be under your purview, and you will communicate regularly with insurance carriers and patients to pursue payments.
Proficiency in the following areas is preferred:
● Post all daily charges for all assigned providers.● Work on aging reports for Medicare and Medicare Advantage plans.● Communication with assigned providers to help improve their documentation and coding.● Speak to the patients about their balances for services and resolve any discrepancies.● Train new employees coding in order to remain consistent across the Practice.● Knowledge of insurance guidelines including HMO/PPO, Medicare, and other payer requirements and systems.● Knowledge of Orthopedic CPT and ICD-10 Coding, as well as modifiers and CCI edits.● Understanding various fee schedules, including but not limited to UCR, Medicare allowable rates, NJ PIP, etc.● Knowledge and understanding of the explanation of benefits (EOB).● Effective verbal communication with insurance payers to resolve issues.● Ability to write solid appeal letters.● Customer service skills for interacting with patients regarding medical claims and payments.● Ability to work well in a team environment, ability to prioritize, and time management.● Problem-solving skills to research and resolve discrepancies, denials, appeals, collections.● Knowledge of medical terminology.● Competent use of Microsoft Office.● Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).● Ability to multitask.● Other office duties as assigned.● Treat all staff and patients with respect and dignity.