AR Specialist

EyeSouth Partners; Atlanta (GA); On-site; USD 45,000 - 64,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k w/ Match

HSA/FSA

Telemedicine

Job summary

EyeSouth Partners, based in Atlanta, GA, is seeking an AR Specialist to manage third-party medical claims processing and assist patients and staff with billing questions. You will prepare, submit, and follow up on claims for MCO, Medicaid, Medicare, private insurance, and workers' compensation.

This role requires at least two years of medical billing experience, familiarity with EHR/EMR systems, and knowledge of CPT/ICD-10 codes.

Qualifications

• Minimum of two (2) years Medical Insurance/Healthcare Billing and Collections experience in a medical practice or health system
• CPC, CPOC, COC certifications a plus
• Six months of previous customer service experience preferred
• Prior experience with an electronic medical record system required (EHR/EMR)
• 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

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
• 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

Skills

Detail oriented

Team player

Strong communication

Customer service

Education

CPC/CPOC/COC certifications (plus)

Tools

EHR/EMR

Microsoft Office (Word/Excel/PowerPoint)

Job description

Company Overview

EyeSouth Partners is a leading physician-founded eye care organization building a premier network of clinical excellence across the nation. Based in Atlanta, we partner with respected eye care physicians to expand access to high-quality medical and surgical specialty services across 14 states.

Our 70+ affiliated practices and 400+ doctors deliver care at 280+ clinic locations and 26 ambulatory surgery centers -and we're growing. We invest in our practices with capital, operational expertise, and strategic resources so physicians and their teams can focus on what matters most: exceptional patient care and clinical outcomes.

We're looking for talented professionals who share our commitment to physician partnership, clinical quality, and patient-first care.

Position Summary

The A/R Specialist is responsible for the company's third-party medical claims processing and assisting patients and office staff with questions on insurance claims, authorizations, statements, and other billing issues. This position will prepare, submit and follow-up on medical claims for Managed Care Organization (MCO), Medicaid, Medicare, Other Federal, Private Insurance, and Workers Compensation.

**Applicants who live and plan to work from the following states will not be considered at this time: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Idaho, Montana, Maryland, Massachusetts, Nevada, New Mexico, Oregon, New Hampshire, New Jersey, Utah, New York, Rhode Island, Washington, and Wyoming. Thank you for your interest.

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
• 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

Qualifications

• Minimum of two (2) years Medical Insurance/Healthcare Billing and Collections experience in a medical practice or health system
• CPC, CPOC, COC certifications a plus
• Six months of previous customer service experience preferred
• Prior experience with an electronic medical record system required (EHR/EMR)
• 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

Company Benefits

• Medical
• Dental
• Vision
• 401k w/ Match
• HSA/FSA
• Telemedicine
• G