Claims and AR Specialist

Central Dermatology Center, PA; Durham (NC); Hybrid; USD 25,000 - 28,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Life insurance

Disability insurance

401k/Profit Sharing

Job summary

Central Dermatology Center, PA is seeking a Claims and AR Specialist to manage revenue cycle tasks related to insurance and patient billing. The role requires proficiency with billing software, understanding medical insurance regulations, and responding to inquiries while protecting patient privacy.

The position starts in the office for training and probation, with potential to shift to hybrid in-office 2 days/week and remote 3 days/week after 90 days, within 8am–5pm hours.

Qualifications

• High school diploma or equivalent; 1–3 years in a medical office.
• Knowledge of medical billing and accounts receivable.
• Familiarity with CPT and ICD-10 coding.

Responsibilities

• Check eligibility and benefits verification for treatments/procedures.
• Review patient bills for accuracy and missing information.
• Prepare, review, and transmit claims using billing software.
• Correct and resubmit rejected claims.
• Process insurance and patient payments from various sources.
• Follow up on unpaid claims within standard cycle.
• Identify and bill secondary or tertiary insurances.
• Research and appeal denied claims.
• Respond to insurance correspondence and patient inquiries.
• Set up patient payment plans and manage collections.
• Refer issues to supervisor for policy changes.
• Balance and reconcile procedures.
• Review unallocated payments and identify refunds.
• Run AR and collection reports.
• Coordinate with providers to reconcile missing charges.
• Maintain knowledge of payer policies incl. Medicare/Medicaid/other governments.

Skills

Communication skills

Customer service

CPT/ICD-10 coding

Teamwork

Problem-solving

HIPAA knowledge

Organization

Privacy compliance

Math & bookkeeping

Education

High school diploma or equivalent

Associates degree

EMA/Modernizing Medicine PM familiarity

Dermatology billing familiarity

Tools

Billing software

EMA/Modernizing Medicine PM

Dermatology billing software

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Claims and AR Specialist

30+ days ago Requisition ID: 1359

Salary Range: $18.00 To $20.00 Hourly

Job Summary:

Central Dermatology Center is looking for an enthusiastic and professional individual to join our team as a Claims and AR Specialist.

This role is responsible for revenue cycle tasks related to insurance and patient billing. You must be well-versed in billing software, medical insurance regulations, and proficient at responding to patient and insurance inquiries. You will also be responsible for maintaining patient confidentiality, handling personal information, and accurately inputting patient data into a billing software system.

Position is in office for the 1 st 90 days of training and probation. Proven completion of training after 90 days can change position to in office 2 days per week and 3 days per week working remotely within the hours of 8am to 5pm.

Job Summary:

Central Dermatology Center is looking for an enthusiastic and professional individual to join our team as a Claims and AR Specialist.

This role is responsible for revenue cycle tasks related to insurance and patient billing. You must be well-versed in billing software, medical insurance regulations, and proficient at responding to patient and insurance inquiries. You will also be responsible for maintaining patient confidentiality, handling personal information, and accurately inputting patient data into a billing software system.

Duties/Responsibilities:

• Checking eligibility and benefits verification for treatments and procedures.
• Reviewing patient bills for accuracy and completeness and obtaining any missing information.
• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
• Correcting and resubmitting rejected claims.
• Processing insurance and patient payments from electronic remittances, lockbox, mail, and payer websites.
• Following up on unpaid claims within a standard billing cycle time frame.
• Checking each insurance payment for accuracy and compliance with contract discount.
• Contacting insurance companies regarding any discrepancy in payments, if necessary.
• Identifying and billing secondary or tertiary insurances.
• Reviewing accounts and performing insurance and/or patient follow-up.
• Researching and appealing denied claims.
• Processing and responding to incoming insurance correspondence, including medical record requests.
• Answering patient or insurance inquiries pertaining to assigned accounts.
• Setting up patient payment plans and work collection accounts.
• Reporting issues and coordinating with the revenue cycle supervisor to implement necessary software and policy changes.
• Following balancing and reconciliation procedures.
• Reviewing unallocated payments and identifying refunds.
• Running A/R and collection reports.
• Coordinating with providers to reconcile missing charges and/or unsigned charts.
• Maintaining appropriate knowledge of payer policies and requirements, including Medicare, Medicaid, other government programs, and commercial insurance carriers.
• Perform other duties as assigned.

Required Skills/Abilities:

• Strong communication skills, including writing, speaking, and active listening.
• Great customer service skills, including interpersonal communication, patience, and empathy.
• Familiarity with CPT and ICD-10 coding.
• Ability to work well in a team environment. Ability to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion.
• Good problem-solving and critical thinking skills.
• In-depth knowledge of industry best practices.
• Basic math, bookkeeping, and accounting knowledge.
• Good organization, time management, and prioritization abilities.
• Ability to be discreet and maintain the privacy and security of patient or customer information.
• Understanding of industry-specific policies, such as HIPAA regulations for healthcare.

Education/Experience:

Required:

• High school diploma or equivalent.
• Knowledge of medical billing and accounts receivable.
• A minimum of 1-3 years of experience in a medical office setting.

Preferred:

• Associates degree.
• Familiarity with EMA/modernizing medicine PM.
• Familiarity with dermatology billing.

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer.

Job Relationships:

• Reports to revenue cycle supervisor.
• Works with other practice staff.

Job Type:

Full time/Hybrid position (40 hours/week) and eligible for a wide range of benefits including health, dental, life, disability and 401k/Profit Sharing retirement plan.

Compensation: $18-$20 / hour based on education and experience.