Medical Billing and AR Specialist -Riverside

Medical Billing and Accounts Receivable (AR) Specialist

Job Description
The Medical Billing and AR Specialist is responsible for processing claims while consistently monitoring, analyzing and taking appropriate action on AR aging for assigned payers or other responsible parties to facilitate claims payment and optimize insurance and patient financial transactions.

Position Responsibilities

• Initiate, submit and resolve claims, claim denials and rejections utilizing payer directed methods of inquiry and submission (e.g., appeal, corrected claim) to ensure filing timelines are met, payer process is followed and claims are brought to resolution.
• Analyze problems and report trends related to denials and payer claim adjudication issues to leadership.
• Maintain appropriate documentation of all Billing and collection activities in the practice management system.
• Correct and resubmit rejected claims in the practice management system and clearinghouse.
• Review and research refund requests from insurance and other payers for appropriateness.
• Identify ways to streamline Billing and collections processes to meet revenue cycle performance metrics.
• Maintain and update patient demographic and insurance information to facilitate claim adjudication and patient billing.
• Other duties as assigned.

Knowledge /Skills / Abilities

• Strong analytical and problem-solving skills
• Meet productivity standards as established by the organization.
• ICD-10, CPT and HCPCS knowledge
• Perform work with a high-level of integrity
• Effective communication skills, verbal and written, to write appeals for denied services, to discuss claim denials and inquiries with payers and to inform management of trends and issues
• Maintain confidentiality of patient information and adhere to HIPAA standards and regulations
• Outstanding organizational skills with the ability to prioritize workload

Job Qualifications

• High School Diploma/GED
• 1 – 2 years’ experience in Medical Billing and collections with thorough understanding of various payers including commercial, managed care, Medicare, Medicaid and Workers Compensation

Benefits

• Full-time, non-exempt Monday through Friday business hours
• Medical, Dental and Vision insurance offered
• 401k retirement plan
• Life Insurance
• Generous PTO allowance and paid holidays