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EyeSouth Partners · 1 day ago

AR Specialist

Jacksonville Beach, FL

Full-time

Onsite

Mid Level

3+ years exp

EyeSouth Partners is dedicated to providing exceptional eye care through their Atlantic Eye Institute. They are seeking an A/R Specialist responsible for processing third-party medical claims, assisting patients and staff with billing inquiries, and ensuring accurate claim submissions and follow-ups.

Health CareMarketingProfessional Services

Responsibilities

Files and processes primary and secondary third-party medical

Verifies all the information for claims processing is complete and

Contacts the appropriate person to obtain missing or unclear billing

Takes billing calls from patients and/or insurance carriers

Prepares daily reports

Prepares deposit for pick-up weekly

Follows-up by website and/or telephone on all unpaid and denied claims to determine next course of action, which may require rebilling missing claims, denied claims or sending additional information on pending claims

Sends appeal letters to insurance

Obtains authorizations when needed

Identifies and corrects charge entry/ billing

Provides proper documentation to insurance companies

Handles insurance company questions, complaints, and/or responds to and interacts with patients concerning all aspects of billing through phone, e-mail, or regular mail in a prompt and courteous

Documents all actions and maintains permanent records of patient

Assists with answering phones, screening calls and following-up on

Works with management on patient billing and insurance

Processes refunds to patients and insurance

Works with outside programs (i.e., co-pay assistance) to ensure proper

Communicates with front office staff to attempt to collect any outstanding patient

Contributes to the team effort by completing other tasks and projects as needed

Qualification

Medical BillingClaims ProcessingInsurance VerificationEHR/EMR SystemsCPTICD10 CodesCPC CertificationCustomer ServiceAttention to DetailTeam PlayerCommunication SkillsOrganizational SkillsInterpersonal Skills

Required

Minimum of three years (3) years Medical Insurance/Healthcare Billing and Collections experience in a medical practice or health system

Prior experience with an electronic medical record system required (EHR/EMR) Modernizing Medicine a plus

Working knowledge of medical billing, collections and payment posting, revenue cycle, third party payers, Medicare; and strong knowledge of Federal payer regulations

Working knowledge of CPT and ICD10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits and appeal processes

Ability to handle sensitive and confidential information in a professional manner

Maintains knowledge of coordination of benefits requirements and processes

Demonstrated success working in a team environment focused on meeting organization goals and objectives is necessary

Self-motivated with strong organizational skills and superior attention to detail

Ability to review documents for accuracy and reasonability

Ability to work well under pressure

Ability to multi-task, set priorities and follow through without direct supervision

Effectively communicate with physicians, patients, insurers, colleagues, and staff

Intermediate computer skills including Microsoft Office; especially Word, Excel, and PowerPoint

Knowledge of policies and procedures to accurately answer questions from internal and external customers

Detail oriented and tolerant of frequent interruptions and distractions from patients and staff

Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external

Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level

Team player that develops strong collaborative working relationships with internal partners and can effectively engage and ability to build consensus among cross-functional teams