Billing Specialist

Job Description

Job Description

Job Summary:

We are a growing Arthritis and Rheumatology Center located in North Georgia, seeking a detail-oriented and experienced Accounts Receivable (A/R) Specialist to join our team in Cumming office. The ideal candidate will have a strong understanding of medical insurance processes, payer policies, and reimbursement procedures. This position is responsible for reviewing and resolving outstanding insurance balances, interpreting Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs), and working closely with insurance payers to ensure timely and accurate payments.

• Maintain full ownership of assigned A/R aging report, prioritizing accounts based on payer deadlines and dollar value

• Aggressively follow up on unpaid, underpaid, and denied claims to ensure timely reimbursement

• Analyze aging balances and take immediate corrective action to prevent accounts from exceeding payer timely filing limits

• Research claim issues and resolve them in accordance with individual payer regulations, contracts, and billing guidelines

• Identify root causes of denials and payment delays and implement corrective actions

• Submit corrected claims, appeals, and reconsiderations within payer-specific timeframes

• Review EOBs and remittance advice to ensure payments align with contracted rates

• Escalate unresolved or systemic payer issues with clear documentation and recommendations

• Communicate professionally and effectively with insurance carriers to resolve discrepancies

• Collaborate with billing, coding, and front-office staff to reduce recurring claim errors

• Maintain strict compliance with HIPAA, payer rules, and practice policies

• Prepare and review A/R and aging reports and provide regular status updates to management

• 2+ years of experience in medical billing, A/R follow-up, or insurance claims resolution.

• Strong understanding of insurance processes (commercial plans, Medicare, BCBS, United Healthcare, etc).

• Proficient in reading EOBs, ERAs, and payer remittance summaries.

• Experience working payer A/R and resolving outstanding claims.

• Excellent verbal and written communication skills for interacting with payers and internal teams.

• Ability to work independently, manage time effectively, and prioritize tasks.

• Familiarity with billing software and eClinicalworks is a must!

• Experience with high-volume A/R follow-up.

• Knowledge of CPT, ICD-10, and HCPCS coding.

• Previous experience working with specific payers (e.g., Aetna, UnitedHealthcare, Blue Cross Blue Shield, Medicare).

• Demonstrate consistent compliance with payer regulations and deadlines

• Identify trends and recommend process improvements to prevent revenue loss

BENEFITS:

• 401(k) matching
• Dental Insurance
• Health Insurance
• Life Insurance
• Vision Insurance

SCHEDULE:

• 8-hour shift
• Monday-Friday
• In person-Cumming, Ga Location

WORK SETTING:

• Clinic
• Office