Medical Billing Specialist
Peyton Resource Group
Medical Accounts Receivable SpecialistOur client is seeking an experienced Medical Accounts Receivable (AR) Specialist to manage all aspects of medical AR collections for a physician medical group. This role will focus heavily on insurance claim denial follow-up, unpaid claims, payment recovery, billing issue resolution, and account management.Key ResponsibilitiesManage assigned medical accounts receivable and insurance payer follow-up to ensure timely payment of outstanding claims.Perform claim denial follow-up, research unpaid and underpaid claims, identify billing issues, and pursue available options to obtain payment.Follow up on zero-payment Explanation of Benefits (EOBs) and determine appropriate next steps for claim resolution.Monitor accounts for delinquent payments and use appropriate collection techniques to maintain current AR.Research and resolve patient billing inquiries, insurance issues, and account discrepancies.Professionally communicate with patients, insurance companies, and clinic staff regarding account balances, claims, payments, and billing concerns.Required QualificationsHigh School Diploma or GED.2+ years of medical billing and/or collections experience, preferably within a physician practice, medical group, hospital, or other healthcare setting.Knowledge of government insurance programs, including Medicare Part B and C, Medicaid and associated Medicare Advantage plans, and TRICARE.Knowledge of commercial insurance plans, including PPO, HMO, EPO, and HRA.Working knowledge of CPT, HCPCS, and ICD-10 coding.Understanding of HIPAA guidelines and the importance of protecting patient information.
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