AR Specialist

Company Overview At Atlantic Eye Institute, our mission is to help our patients live their vision through exceptional, compassionate and honest eye care for every stage of life. And treat them like members of our family—because they are. Living Our Vision: They say seeing is believing. But we say it’s much more than that. Seeing is how the story of our life is told. A journey that unfolds through your very own eyes. A journey we’re on together, every step of the way—from a child’s first eye exam, to their first pair of glasses and contacts, to LASIK, and even cataracts, we help you see the world better at every stage in your life. Any age, any problem, any time, we will be there. That’s because at Atlantic Eye Institute we believe in the power of seeing things clearly. Every vivid color. Every precise movement. Every memory. And so, our team remains committed to you, from the most advanced technology and personalized care to being available 24/7 and always doing the right thing. This is our vision for you: A world where seeing isn’t just believing; seeing clearly is living fully. That’s why at Atlantic Eye Institute, we not only help improve your vision—we help you Live Your Vision. We invite you to join our team! Position Summary The A/R Specialist is responsible for the company’s third-party medical claims processing and assisting patients and office staff with questions on insurance claims, referrals, authorizations, statements, and other billing issues. This position will prepare, submit and follow-up on medical claims for Commercial, Managed Care Organization (MCO), Medicare, Other Federal, Private Insurance, and Workers Compensation. This position will also assist with Billing Calls, verification and benefits, bank deposits, assist with answering staff questions regarding billing process. Responsibilities Files and processes primary and secondary third-party medical Verifies all the information for claims processing is complete and Contacts the appropriate person to obtain missing or unclear billing Takes billing calls from patients and/or insurance carriers Prepares daily reports Prepares deposit for pick-up weekly Follows-up by website and/or telephone on all unpaid and denied claims to determine next course of action, which may require rebilling missing claims, denied claims or sending additional information on pending claims Sends appeal letters to insurance Obtains authorizations when needed. Identifies and corrects charge entry/ billing Provides proper documentation to insurance companies. Handles insurance company questions, complaints, and/or responds to and interacts with patients concerning all aspects of billing through phone, e-mail, or regular mail in a prompt and courteous Documents all actions and maintains permanent records of patient Assists with answering phones, screening calls and following-up on Works with management on patient billing and insurance Processes refunds to patients and insurance Works with outside programs (i.e., co-pay assistance) to ensure proper Communicates with front office staff to attempt to collect any outstanding patient Contributes to the team effort by completing other tasks and projects as needed Qualifications Minimum of three years (3) years Medical Insurance/Healthcare Billing and Collections experience in a medical practice or health system CPC, CPOC, COC certifications a plus Six months of previous customer service experience preferred Prior experience with an electronic medical record system required (EHR/EMR) Modernizing Medicine a plus Working knowledge of medical billing, collections and payment posting, revenue cycle, third party payers, Medicare; and strong knowledge of Federal payer regulations Working knowledge of CPT and ICD10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits and appeal processes Ability to handle sensitive and confidential information in a professional manner Maintains knowledge of coordination of benefits requirements and processes Demonstrated success working in a team environment focused on meeting organization goals and objectives is necessary Self-motivated with strong organizational skills and superior attention to detail Ability to review documents for accuracy and reasonability Ability to work well under pressure Ability to multi-task, set priorities and follow through without direct supervision Effectively communicate with physicians, patients, insurers, colleagues, and staff Intermediate computer skills including Microsoft Office; especially Word, Excel, and PowerPoint Knowledge of policies and procedures to accurately answer questions from internal and external customers Detail oriented and tolerant of frequent interruptions and distractions from patients and staff Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level Team player that develops strong collaborative working relationships with internal partners and can effectively engage and ability to build consensus among cross-functional teams Company Benefits We offer a competitive benefits package to our employees: Medical Dental Vision 401k w/ Match HSA/FSA Telemedicine Generous PTO Package We also offer the following benefits for FREE: Employee Discounts and Perks Employee Assistance Program Group Life/AD&D Short Term Disability Insurance Long Term Disability Insurance EyeSouth Partners is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. #J-18808-Ljbffr