Insurance AR Specialist
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Job Description
Insurance AR Specialist submitting medical claims and resolving billing issues for OrthoLoneStar. Processing denials, appeals, underpayments, refunds, and accounts-receivable reconciliations.
Responsibilities:
- Review and submit clean claims electronically or on paper to insurance companies
- Contact carriers by phone or website regarding outstanding insurance balances and claim status
- Process insurance correspondence and collection actions
- Contact patients, correct claims, and resubmit them to other carriers
- Obtain documentation needed to expedite insurance payments
- Answer questions from patients, clerical staff, and insurance companies
- Identify and resolve patient billing complaints
- Prepare appeal letters for denied claims
- Document collection activities according to established guidelines
- Identify underpayments by comparing payments with contracted fee schedules
- Process insurance refund requests
- Report payer issues or delays to the supervisor
- Participate in educational activities
- Maintain confidentiality and comply with HIPAA guidelines and regulations
- Manage workload, prioritize assignments, and recommend solutions
- Reconcile accounts receivable accurately and promptly
- Review claims stopped in the claim scrubber
- Work claims rejected by the clearinghouse
Requirements:
- High School Diploma or GED
- Minimum one year of experience in a medical billing/collections field
- Ability to read and write
- Ability to add, subtract, multiply, and divide using whole numbers, common fractions, and decimals
- Ability to interpret explanation of benefits remittances to identify claim denial reasons and required resolutions
- Ability to type 45 WPM
- Basic proficiency in Microsoft Outlook/Office
- Experience using or ability to learn and comprehend computer programs
- Ability to perform each essential duty satisfactorily
- Ability to manage workload and prioritize accordingly
- Ability to maintain strict confidentiality and adhere to HIPAA guidelines/regulations
- Ability to solve problems and recommend solutions
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