Billing & A/R Specialist

Job Description

Job Description

OnPoint Medical Group is searching for an outstanding Billing & A/R Specialist to join our team! Come join a great group of medical professionals as our network continues to grow!

OnPoint Medical Group is a physician-led network of skilled Primary and Urgent care providers who are committed to expanding access to quality healthcare in the most effective and affordable manner possible.

Our "Circle of Care" has one primary goal – to ensure the health and wellness of members and their families. We do this by providing access to a comprehensive menu of medical services from one unified physician group in their neighborhoods. With doctors, nurses, specialists, labs and medical records all interlinked and coordinated, patient care has never been in better hands.

Billing and A/R specialist requirements include full revenue cycle duties including submitting a clean claim and/or assisting with said submission, verify contractual payment is received and/or appealing a denial, answering patient phone calls and reviewing patient statements, working A/R.

OnPoint Medical Group is seeking an outstanding Billing & Accounts Receivable (A/R) Specialist to join our growing team. This is an excellent opportunity to become part of a physician-led organization committed to delivering high-quality, accessible, and affordable healthcare. This position is located on-site in the Highlands Ranch, CO corporate office.

Position Summary

The Billing & A/R Specialist is responsible for supporting all aspects of the revenue cycle, including claims submission, payment review, denial follow-up, appeals, patient account support, and accounts receivable management. This role requires strong attention to detail, knowledge of medical billing processes, and the ability to communicate effectively with patients, providers, and insurance carriers.

Essential Duties and Responsibilities

The following statements describe the essential functions of this role. They are not intended to be an exhaustive list of all duties, responsibilities, or qualifications required. OnPoint Medical Group reserves the right to modify job responsibilities at any time.

Accounts Receivable Collections and Management

• Work directly with insurance companies, healthcare providers, and patients to ensure claims are processed accurately and paid in a timely manner.
• Submit clean claims or assist with claim submission as needed.
• Verify contractual payments and investigate payment discrepancies.
• Review, correct, and appeal unpaid or denied claims.
• Run and analyze A/R reports.
• Work unpostables, denials, and claim worklists in accordance with Athenahealth best practices.
• Respond to patient calls regarding billing questions and account statements.
• Review and resolve outstanding accounts receivable balances.

Productivity Expectations

• Resolve a minimum of 37 claims per day from assigned claim worklists.
  • Goal may vary based on payor type, projects, other assignments etc.
• Maintain accounts receivable balances at less than 180 days outstanding.
• Answer patient billing calls based on assigned phone responsibilities and minimize voicemail backlogs.

Compliance and Policies

• Perform duties in accordance with the standard Billing Compliance and Billing Guidelines .
• Maintain and follow strict privacy, confidentiality, and safety standards.
• Comply with all applicable governmental and regulatory requirements, including:
  • HIPAA
  • OSHA
  • PCI DSS

Administrative Support

• Maintain a clean, organized, and professional work environment.
• Distribute faxes and related documents to billing department staff, as appropriate.
• Perform other administrative duties as assigned.

Qualifications

To perform this job successfully, an individual must be able to carry out each essential duty satisfactorily. The qualifications listed below are representative of the knowledge, skills, and abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Minimum Qualifications

• High school diploma or equivalent
• Strong computer skills
• Minimum of 5 years of healthcare experience
• Minimum of 1 year of medical billing experience

Preferred Qualifications

• Some college coursework in medical administration, business, or accounting
• Bilingual skills
• Experience with electronic medical records (EMR), preferably Athenahealth Practice Management
• Certified biller and/or coder preferred
• Equivalent combination of 5+ years of billing, coding, or advanced insurance knowledge may be considered

Customer Service Expectations

• Provide service that aligns with the mission and values of the clinic.
• Demonstrate courtesy, professionalism, and respect when interacting with patients, family members, and colleagues.
• Maintain patient confidentiality in accordance with company policy, procedure, and HIPAA requirements.
• Follow appropriate chain-of-command procedures when addressing patient concerns or complaints.

Professional Attributes

• High level of energy and adaptability in a fast-paced environment
• Ability to make sound, fact-based decisions
• Commitment to compassion, quality, loyalty, and conscientiousness
• Ability to establish and maintain effective working relationships with patients, families, and staff

Supervisory Responsibilities: This position has no supervisory responsibilities .

Working Conditions and Physical Requirements

• Regularly required to stand; use hands to handle or feel; reach with hands and arms; and talk or hear
• Occasionally required to walk, sit, and stoop, kneel, crouch, or crawl
• Frequently lift and/or move up to 10 pounds and occasionally lift and/or move more than 25 pounds
• Specific vision abilities required include close vision, distance vision, and the ability to adjust focus

Work Environment

The statements above describe the general nature and level of work performed by employees assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. Employees may be asked to perform duties outside their normal responsibilities as needed.

BENEFITS OFFERED

• Health insurance plan options for you and your dependents
• Dental, and Vision, for you and your qualified dependents
• Company Paid life insurance
• Voluntary options for short-term disability, and long-term disability coverage
• AFLAC Plans
• FSA options
• Eligible for 401(k) after 6 months of employment with a 4% match that vests immediately
• Paid Time-Off earned

Salary: $21 - $27 / hour

The estimate displayed represents the typical salary range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role.