AR Specialist

Role Overview

• Ensure strict HIPAA-compliant confidentiality with all client-related data
• Review customer account reports and follow up to ensure any flags/concerns are notated proactively and communicated to the Customer Billing Advocate (CBA)
• Review A/R Aging Reports and follow up with insurance companies regarding expected reimbursement for outstanding claims
• Notate & document all follow up work on aging claims within A/R Aging Reports as required and documented in standard SOPs
• Meet expectations on deadlines for completion of A/R Aging Reports for each customer supported within POD
• Follow up on denials immediately and communicate any trends to CBA
• Follow up on any open A/R tickets in Salesforce as assigned by CBA
• Meet deadlines assigned for A/R work as assigned by CBA
• Utilize denial management platforms for submission of appeals, reconsideration requests, etc.
• Research specific payor billing rules as needed
• Follow up on claims submitted electronically for primary and secondary payors
• Submit corrected claims when needed
• Attend POD meetings and contribute to agenda items as designated by CBA
• Post payments or submit missing payments to posting team and maintain A/R as assigned
• File appeals to insurance and to insurance commissioner as needed
• Stay informed about Payor and Industry Billing rules
• Review & interpret payor contracts when applicable
• Measure and monitor key metrics related to work performance
• Attend customer meetings as needed with CBA
• Work to meet POD goals collectively as cohesive team
• Foster a positive work environment for colleagues

Requirements

• HS Diploma or Equivalent
• ABA billing experience
• Min. 1-year experience in billing; major commercial insurance companies and state Medicaid programs
• Experience using insurance company websites/portals
• Proficient in using Microsoft Suite (Outlook, Excel, Word)
• Willing to learn, positive attitude and love a good challenge
• Professional writing & phone skills

Benefits

• PTO and Vacation Days after a 90-day introductory period
• Paid Holidays
• Generous Health, Denial & Vision benefits package
• 401k + Matching