Address
SalaryAbout Bay Area Retina Associates
Bay Area Retina Associates (BARA) is an established Ophthalmology practice with over 35 years in the industry, renowned as a premier group of highly skilled ophthalmologists specializing in state-of-the-art retinal treatments. With nine conveniently located facilities across the Bay Area, our unwavering commitment is to provide high-quality care to our patients.
JobSummary
Bay Area Retina Associates is looking for an AR Specialist in Revenue Cycle Management, responsible for managing the overall payer accounts receivables and any additional accounts with additional needs. This position responsible for resolving and root causing accounts receivables to ensure accuracy in accounts. The AR Specialist reviews, develops, and/or modifies procedures, systems, and protocols to achieve and maintain payer guidelines with billing requirements and compliance standards.
Responsibilities
- Monitor, report and advise RCM Manager of any potential billing issues as it pertains insurance carriers and payment resolution
- Assists in resolution of any account issues that affect patient accounts
- Responsible for the billing, charge entry, payment posting, eligibility, coverage, patient collections, and overpayment resolution
- Contact payers for appeals, documentation needs, reconsiderations, adjustments, claims corrections and any other activity that pertains to resolution of claim issues
- Ensure that all patient information is accurate and complete and request any missing patient information.
- Interact with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations; obtain clarification of conflicting, ambiguous, or non-specific documentation
- Resolve posting issues, manage remittance and all correspondence (relationship with Clearinghouse as applicable)
- Complete follow-up of patient accounts to maximize reimbursement; Monitor and execute work on assigned claim worklists, AR worklists
- Insurance or program payments or takebacks that have been received and the balance due has been transferred to patient responsibility
- Ensure strict confidentiality of financial and medical records
- Illustrate excellent knowledge of healthcare industry regarding the Revenue Cycle, coding, claims, and state insurance laws
- Assists with coding issues and determines course of action
- Assist RCM Manager & RCM Director in other areas as required
- Meet department/team qualitative and quantitative targets
- Build sustainable relationships and engage patients by going the extra mile
- Possess strong computer skills and the ability to maneuver multiple resources
- Comply with all HIPAA rules and regulations; obtain 2 patient identifiers with each interaction
- Other duties as assigned
Education
- High School Diploma/GED
- Business Admin, Healthcare or other related field degree
Experience
- 2 years of billing in Medical Office or Hospital
- 2 years of EMR/EHR experience
- 2 years of Ophthalmology/Retina experience preferred
- 2 years of California Payer experience
- 1 year of Clearing House experience preferred
Other Requirements
- Making Decisions and Solving Problems - Analyzing information and evaluating results to choose the best solution and solve problems.
- Establishing and Maintaining Interpersonal Relationships - Developing constructive and constructive and cooperative working relationships with others and maintaining them over time.
- Evaluating Information to Determine Compliance with Standards - Using relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards.
- Getting Information - Observing, receiving, and otherwise obtaining information from all relevant sources.
- Analyzing Data or Information - Identifying the underlying principles, reasons, or facts of information by breaking down information or data into separate parts.
- Guiding and Motivating
- Monitor and execute work on RCM initiatives
- Run reports for analysis, trending, and subdivision of work to communicate to key stakeholders
- Communicate trends and root issues through proper lines of reporting
- Meet productivity and Key Performance Indicator standards
- Resource person for coding specialty
- Some travel may be required
Benefits
- Medical, Dental, Vision and Life Insurance
- 401(k) and Cash Balance Plan with Employer Contributions and Profit Sharing
- Rich PTO Plan
- 9 Paid Holidays
- Birthday off
