Essential Job Responsibilities:

The Accounts Receivable Billing Specialist is responsible for:

 

Work aged receivables utilizing A/R reports assigned by manager Review and assess adjudicated claims for timely and proper payment of outstanding balances Research, correct, and resubmit or reprocess unpaid claims as necessary Verify validity of account balance by researching, reviewing and ensuring accuracy of payment and adjustment posting Identify liability and guarantor hierarchy and transfer balances timely and appropriately Review and interpret Explanation of Benefits (EOB) for denials and underpayment of codes Research and resolve denials and underpayments with insurance carriers Verify all identified insurance carriers for eligibility and confirm carrier policy for referral and authorization requirements as needed for claims adjudication Submit carrier appeals and reconsideration requests in a timely manner Meet productivity goals/benchmarks as set and communicated by Team Lead Maintain confidentiality of patient information Work collaboratively with other Coding, Billing, Patient Success, and Payment Posting Specialists as needed

 

 

 

Education:

High school diploma or GED Bachelor’s degree preferred

 

 

 

 

Experience:

Minimum of 3 years' billing experience in the healthcare industry Prior medical billing experience Knowledge of ICD-10, CPT, HCPCS coding and medical terminology required Problem-solver/ Critical thinking skills/ Self-motivated Ability to organize, prioritize and manage various work assignments in a timely fashion Word and Excel experience preferred Ability to remain professional and courteous with providers and insurance carries always Experience with Availity and/or Telcor is preferred