AR Specialist

Description Duties/Responsibilities include but are not limited to: Effectively review and research claims denials and contact payers to verify detailed denial reasons when necessary Contact patients to obtain accurate insurance information. Prepare documentation and file reconsiderations and appeals as appropriate. Able to identify and communicate denial/rejection trends to management Able to identify and resolve discrepancies Navigate and research insurance policies & benefits for policy exclusions for patients. Navigate and research payer medical reimbursement policies and exclusions. Review and work all daily correspondence received from patients and payers. Understand and act on the timely filing guidelines associated with claims filing, reconsiderations, and appeals for assigned payers. Review accounts for accuracy (payments and adjustments) Knowledge of medical EOB’s, patient deductibles and co pays, and insurance or third-party correspondence Experience working with payer websites Experience in working aged AR EDI transactions/troubleshooting Other assigned duties Description Duties/Responsibilities include but are not limited to: Effectively review and research claims denials and contact payers to verify detailed denial reasons when necessary Contact patients to obtain accurate insurance information. Prepare documentation and file reconsiderations and appeals as appropriate. Able to identify and communicate denial/rejection trends to management Able to identify and resolve discrepancies Navigate and research insurance policies & benefits for policy exclusions for patients. Navigate and research payer medical reimbursement policies and exclusions. Review and work all daily correspondence received from patients and payers. Understand and act on the timely filing guidelines associated with claims filing, reconsiderations, and appeals for assigned payers. Review accounts for accuracy (payments and adjustments) Knowledge of medical EOB’s, patient deductibles and co pays, and insurance or third-party correspondence Experience working with payer websites Experience in working aged AR EDI transactions/troubleshooting Other assigned duties Requirements Applicants must have: eClinicalWorks experience is preferred HST experience is strongly preferred Minimum of 2-4 years of medical billing, collections, and/or payment posting experience High school diploma or GED Candidate must exhibit excellent time management, organizational skills, and be computer literate. Ability to prioritize workload 10 Key – accuracy and proficiency Ability to work independently and adapt to a fast-changing environment Knowledge of Medicare, Medicaid, Medicaid MCO’s, and commercial insurance. Strong problem-solving and critical thinking skills Strong interpersonal and communications skills Must have ICD-10/CPT knowledge Adhere to all HIPAA guidelines/regulations #J-18808-Ljbffr Pain Specialists of America