AR / Medical Billing Specialist

We’re looking for a skilled and committed AR / Medical Billing Specialist to join our team. As the AR / Medical Billing Specialist you will be responsible for analyzing data, evaluating information, and making sound decisions. Your daily tasks will include managing billing software, appealing denied claims, following up on insurance claims, taking action, reviewing denials, reviewing rejections, and tracking late payments. To excel in this role, it is essential to have a thorough understanding of billing software and medical insurance policies.

Additionally, strong written and verbal communication skills are required as communicating with clients and insurance agents will be a significant aspect of the job. If you are a self-motivated individual with a passion for medical billing and a commitment to providing excellent customer service, we encourage you to apply.

Responsibilities:

• Preparing and submitting billing data and medical claims to insurance companies.
• Verify all demographic and insurance information in patient registration of the practice managemet system at the time of charge entry to ensure accuracy.
• Responsible for insurance verification processes of verifying patient eligibility, coordinating medical benefits, gaining approval for planned procedures and services, and determining patient coverage/responsibility for services to be provided.
• Ensuring the patient’s medical information is accurate and up to date.
• Preparing bills and invoices, and documenting amounts due for medical procedures and services.
• Collecting and reviewing referrals and pre-authorizations.
• Clearing house rejections need to be rectified in timely manner.
• Contacting various payers as needed to verify or obtain information.
• Ensuring client satisfaction by an effective and regular follow-up on all outstanding claims to maximize the collection of practice.
• Monitoring and recording late payments.
• Maintain the protocols and documentation of each performed task.
• Following up on missed payments and resolving financial discrepancies.
• Follow-Up on unpaid claims within the Standard Billing Cycle timeframe.
• Communicating with Providers, Insurance Companies and assisting Patients.
• Handling Account Receivables, Denial Management, and Appeal Management.
• Maintaining accurate records of payments received and outstanding balances.
• Working with the Billing Manager to ensure that all payments are processed.
• Examining patient bills for accuracy and requesting any missing information.
• Investigating and appealing denied claims.
• Swift and accurate remedial actions on claims denied by healthcare insurances.
• Verify any secondary and tertiary medical insurance benefits.
• Understanding of relevant Key Performance Indicators (KPIs) and working towards positive results for the assigned clients against all KPIs.
• Monitor and track patient authorizations, obtain updated authorizations for ongoing treatment, and communicate changes to appropriate team members.
• Verify private, government and third-party insurance information, including eligibility, out-of-pocket costs, prescription coverage and patient portions.
• Maintaining patient confidentiality and information security.
• Perform additional duties as requested by Supervisory or Management team.
• Ensure the quality of service, timeliness and accuracy in the entire billing cycle.
• Carry out routine communication with your Superiors and provide them daily updates.

Requirements:

• Bachelor’s degree in business, health care administration, accounting, or a relevant field.
• Excellent communication and interpersonal skills.
• A minimum of 3 years of experience as an A/R or RCM Specialist or similar role.
• Solid understanding of billing software and electronic medical records.
• Must have the ability to multitask and manage time effectively.
• Excellent written and verbal communication skills.
• Outstanding problem-solving and organizational abilities.
• Proficiency in Microsoft Office.
• Ability to work independently and in a team environment.
• Strong attention to detail and accuracy.
• Eagerness to learn and grow in the field.