AR Follow Up Specialist

Ohio Gastroenterology Group, Inc.; Columbus (OH); On-site; USD 36,000 - 54,000; Full time

Benefits offered by this job

Health benefits

Life insurance

Paid time off

Retirement plans

401(k) matching

Training programs

Job summary

Ohio Gastroenterology Group, Inc. in Columbus, OH is seeking a Medical Billing Specialist to manage third-party payer follow-up and AR workloads. You will validate claims, resolve denials, prepare appeals, and post adjustments while maintaining HIPAA compliance.

The role collaborates with billers and other departments to resolve unpaid balances, ensure timely filing, and optimize cash flow. A high school diploma and 1 year billing experience are preferred.

Qualifications

• Must have 1 year of medical billing and AR follow-up experience.
• Knowledge of third-party payer processes and HIPAA.
• Strong attention to detail and ability to multi-task.

Responsibilities

• Monitor unresolved balances and follow up with payers.
• Review EOBs and file appeals as needed.
• Collaborate with billers and departments to resolve unpaid balances.

Skills

Medical billing

AR follow-up

HIPAA

Microsoft Office

Communication

Attention to detail

Education

High school diploma

Tools

eClinicalWorks

Job description

• Monitors unresolved account balances according to the Aged Receivables and assigned tasks
• Validates third-party payer transactions and identifies reasons for delay of payment through the review of EOBs via paper, payer portals, and/or phone calls, determines next steps, and documents actions taken in the billing system
• Maintains knowledge of third-party filing requirements and ensures claims are not rejected due to timely filing
• Resolves third-party claim rejections and/or denials in a timely manner
• Prepares appeals via appropriate means according to carrier guidelines for all claims that require reconsideration for appropriate or additional payment
• Makes necessary claim adjustments and rebills third party payers as needed
• File claims to secondary payers with primary EOB’s/COB information
• Collaborates with the billers and other internal departments to satisfy the requirements for resolving unpaid insurance balances
• Posts adjustments, transfer of responsibility, and/or initiates refunds, as necessary.
• Ensures coding is compliant and up to date
• Performs all routine follow-up functions which includes the investigation of overpayments, underpayments, credit balances and payment delays.
• Ensures payments are made according to third-party contracts
• Reports payer specific issues to Revenue Cycle Supervisor in a timely manner
• Conveys observations of trends to the Revenue Cycle Supervisor to encourage best practices and mitigate repeat issues
• Makes recommendations to the Revenue Cycle Supervisor regarding non-collectable accounts
• Other duties as assigned.

Secondary Job Functions

• Opening, sorting, delivering and scanning incoming correspondence
• Processes all Returned Mail including skip tracing and contacting various resources for information
• Assists with data entry
• Attend meetings and training sessions
• Maintain confidentiality of patient and financial information by utilizing HIPAA guidelines and regulations
• Maintain knowledge and adhere to related governmental regulations and all policies set forth by Ohio Gastroenterology Group Inc and its related parties

Knowledge, Skills and Abilities

• Knowledge of third-party payers and prior-authorization requirements
• Understanding of basic medical terminology and procedures
• Proficient use of office equipment, such as copier and fax machine, phones, etc.
• Intermediate computer skills including use of Microsoft Office (Excel and Word), electronic mail, payer websites, physician practice management, and electronic medical records systems.
• High attention to detail and the ability to multi-task.
• Ability to work independently with minimal supervision and to manage multiple priorities.
• Strong written and verbal communication skills
• Ability to effectively communicate with a variety of people under stressful circumstances.
• Neat appearance, professional demeanor and pleasant voice

Credentials and Experience

• Must have high school diploma or equivalent
• One (1) year of medical billing and coding, revenue cycle, and/or AR follow-up experience
• Experience with eClinicalWorks a plus
• Experience in GI a plus

Physical Demands

• Must be able to bend over (frequent), climb stairs (frequent), sit (frequent), stand (frequent), stoop (frequent), walk (frequent) and type on keyboard (frequent).
• Minimal medical office exposure that may require contact with adult patients
• Office workstation environment with numerous employees

Ohio Gastroenterology Group offers a nice life/work balance and a great benefits package that includes:

• Medical, dental and vision coverage- benefits are effective the first of the month following 30 days of employment
• Company paid life insurance and short term disability
• Generous paid time off plans (vacation, sick and personal)
• 7 paid holidays
• Two retirements plans:
• 401(k) plan that offers a 3% safe harbor contribution with immediate vesting as well as annual profit sharing contributions.
• Cash balance pension plan – company contributes 2.5% and offers full vesting after 3 years of employment.
• Employee appreciation programs
• Growth opportunities
• Learning and development training

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.