AR Specialist

Join Houston Retina Associates At Houston Retina Associates, we’re more than a leading ophthalmology practice—we’re a team dedicated to preserving and restoring vision for our patients. Specializing in advanced care for retinal conditions like macular degeneration, diabetic retinopathy, and retinal detachment, we combine cutting‑edge technology with compassionate, personalized treatment. Our culture is built on collaboration, innovation, and continuous learning. We value every team member’s contribution and provide opportunities for professional growth in a supportive environment. With multiple locations across the greater Houston area, we’re proud to serve our community and make a meaningful impact every day. We invite you to join our team if you’re passionate about excellence in patient care and want to be part of a group that truly makes a difference. 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, authorizations, statements, and other billing issues. This position will prepare, submit, and follow up on medical claims for Managed Care Organization (MCO), Medicaid, Medicare, Other Federal, Private Insurance, and Workers Compensation. This is a Hybrid Position; the A/R Specialist will be expected to work in person at our Houston Office one day a week. Responsibilities Applicants who live and plan to work from the following states will not be considered at this time: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Idaho, Montana, Maryland, Massachusetts, Michigan, Nevada, New Mexico, Oregon, New Hampshire, New Jersey, Utah, New York, Rhode Island, Washington, and Wyoming. Files and processes primary and secondary third‑party medical claims. Verifies all information for claims processing is complete. Contacts the appropriate person to obtain missing or unclear billing information. 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 companies. 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 manner. Documents all actions and maintains permanent records of patient billing. Assists with answering phones, screening calls, and following up on inquiries. 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 billing. Communicates with front office staff to attempt to collect any outstanding patient balances. Contributes to the team effort by completing other tasks and projects as needed. Qualifications Minimum of two (2) 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). 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 ICD‑10 codes, HCFA 1500, UB‑04 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 build consensus among cross‑functional teams. Benefits Medical Dental Vision 401k with Match

HSA/FSA

Telemedicine Generous PTO Package Additional Benefits (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 EyeSouth Partners