Medical AR Specialist: Claims & Billing Expert

EyeHealth Northwest; Portland (OR); On-site; USD 42,000 - 65,000; Full time

Job summary

EyeHealth Northwest is seeking an Accounts Receivable Specialist to manage billing with medical and vision insurers, process claims daily, post payments, and monitor overdue accounts. You will ensure accurate patient data, resolve denials, and maintain HIPAA-compliant records.

Role requires a high school diploma, at least two years of relevant experience, and familiarity with CPT/ICD10 coding. On-site work in Portland, OR, with strong customer service and attention to detail.

Qualifications

• High school diploma or equivalent.
• Minimum of two (2) years of relevant experience.
• An equivalent combination of education, experience and training that would provide the knowledge, skills and abilities required for the successful performance of the essential job duties.
• Knowledge of medical billing procedures, including CPT and ICD10 coding with familiarity with HCPC coding.

Responsibilities

• Process charges that are directly billed to medical and vision insurers, review and process paper and electronic claims daily.
• Calculate, prepare, and issue bills, invoices, account statements and other financial records according to established procedures.
• Review and research all patient accounts for adequate third-party billing details.
• Audit insurance claims for accurate charges, ICD10 and CPT codes and contractual requirements; identify and resolve coding discrepancies.
• Investigate, resolve and process claim denials; correct claims denied by electronic edits and resubmits according to the insurance payer guidelines.
• Receive payments and post amounts paid to patient accounts.
• Locate and monitor overdue accounts.
• Respond to and research patient inquiries regarding accounts; provide superior customer service at every interaction.
• Ensure patient account information is updated in a timely manner, including all patient data and insurance information.
• Coordinate work with clinic staff to ensure accurate and thorough patient data and claim information.
• Notify supervisor or Director of any discrepancies or problems with any AR processes or payer issues.
• Post Nextgen batches daily and follow up on any AR issues in a timely manner.
• Maintain security and confidentiality of all patient account information.
• Perform work in compliance with company policy, department procedures and regulatory requirements, including HIPPA.

Skills

Medical billing

CPT coding

ICD10 coding

Windows proficiency

Communication skills

Confidentiality

Detail oriented

Patient accounts

Education

High school diploma or equivalent

Tools

NextGen

10-key by touch

Job description

EyeHealth Northwest is seeking an Accounts Receivable Specialist to manage billing with medical and vision insurers, process claims daily, post payments, and monitor overdue accounts. You will ensure accurate patient data, resolve denials, and maintain HIPAA-compliant records.

Role requires a high school diploma, at least two years of relevant experience, and familiarity with CPT/ICD10 coding. On-site work in Portland, OR, with strong customer service and attention to detail.