AR Specialist

Psadocs; United States; Remote; USD 42.000 - 64.000; Vollzeit

Zusammenfassung

Psadocs is seeking a Medical Billing Specialist to review denials, gather insurance details, and file appeals. You will identify denial trends, liaise with payers and patients, and ensure timely filing and accurate postings.

The role requires 2–4 years of experience, knowledge of ICD-10/CPT, and strong communication skills to navigate Medicare, Medicaid, and commercial plans in a fast-paced environment.

Qualifikationen

• Minimum of 2–4 years in medical billing, collections, or payment posting.
• High school diploma or GED.
• Knowledge of Medicare, Medicaid, Medicaid MCOs and commercial insurance.
• ICD-10/CPT knowledge and HIPAA compliance.
• Ability to work independently in a fast-changing environment.
• Strong time management and organizational skills.
• Excellent interpersonal and communication skills.

Aufgaben

• Review denials and contact payers to verify denial reasons.
• Contact patients to obtain accurate insurance information.
• Prepare documentation and file reconsiderations and appeals.
• Identify denial trends and communicate them to management.
• Resolve discrepancies in accounts and payments.
• Research insurance policies, benefits, and exclusions for patients.
• Work with payer websites and perform EDI troubleshooting.
• Review daily correspondence from patients and payers.
• Adhere to timely filing guidelines for claims, reconsiderations, appeals.
• Know Medicare, Medicaid rules and ICD-10/CPT requirements.

Kenntnisse

Time management

Organizational skills

Independent worker

ICD-10/CPT knowledge

HIPAA compliance

Strong communication

Problem solving

Ausbildung

High school diploma or GED

Tools

eClinicalWorks

HST

Jobbeschreibung

Duties/Responsibilities include but are not limited to:

• Effectively review and research claims denials and contact payers to verify detailed denial reasons when necessary
• Contact patients to obtain accurate insurance information.
• Prepare documentation and file reconsiderations and appeals as appropriate.
• Able to identify and communicate denial/rejection trends to management
• Able to identify and resolve discrepancies
• Navigate and research insurance policies & benefits for policy exclusions for patients.
• Navigate and research payer medical reimbursement policies and exclusions.
• Review and work all daily correspondence received from patients and payers.
• Understand and act on the timely filing guidelines associated with claims filing, reconsiderations, and appeals for assigned payers.
• Review accounts for accuracy (payments and adjustments)
• Knowledge of medical EOB’s, patient deductibles and co pays, and insurance or third-party correspondence
• Experience working with payer websites
• Experience in working aged AR
• EDI transactions/troubleshooting
• Other assigned duties

Requirements

Applicants must have:

• eClinicalWorks experience is preferred
• HST experience is strongly preferred
• Minimum of 2-4 years of medical billing, collections, and/or payment posting experience
• High school diploma or GED
• Candidate must exhibit excellent time management, organizational skills, and be computer literate.
• Ability to prioritize workload
• 10 Key – accuracy and proficiency
• Ability to work independently and adapt to a fast-changing environment
• Knowledge of Medicare, Medicaid, Medicaid MCO’s, and commercial insurance.
• Strong problem-solving and critical thinking skills
• Strong interpersonal and communications skills
• Must have ICD-10/CPT knowledge
• Adhere to all HIPAA guidelines/regulations