Medical AR Specialist: Denials & Collections Expert

U.S. Dermatology Partners; Tyler (TX); On-site; USD 36,000 - 60,000; Full time

Job summary

U.S. Dermatology Partners is seeking an accounts receivable specialist to manage medical billing for insurance payors and patients, maximizing collections. The role liaises between practices, clinics, the business office, payors, and patients, and requires handling calls, maintaining accurate AR status, and upholding confidentiality.

The position emphasizes following approved processes, adherence to HIPAA, and ensuring high-quality customer service while supporting KPI targets.

Qualifications

• Three (3)+ years of medical billing and accounting experience.
• Thorough knowledge of medical accounts receivable collection procedures.
• Thorough knowledge of Medicare rules and regulations.
• Thorough knowledge of medical billing procedures and medical insurance, including credit and collection procedures.
• Detail oriented, professional attitude, reliable.
• Able to communicate effectively in English, both verbally and in writing.
• Proficiency with Microsoft Excel, Word, and Outlook.
• Specialty knowledge of systems relating to job function.
• Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines.

Responsibilities

• Follows-up on unpaid insurance claims after denial, to obtain settlement of claim.
• Keys data into computer to maintain billing records and prepare insurance form with data such as names of insurance company and policy holder, policy number, and physician diagnosis.
• Contacts insurance company to verify patient coverage and obtain information concerning extent of benefits.
• Generates appropriate paper work, including insurance claim forms and collection letters, mails monthly statements to patients.
• Reviews all insurance claim forms for accuracy and makes appropriate corrections for refiling.
• Reviews all insurance payments (EOBs), including Medicare and Medicaid payments for accuracy in account information and demographics.
• Determines adjustments of claims paid at the out-of-network rate to in-network rates, and processes write-offs on these adjustments.
• Reposts payments, including insurance and patient payments to appropriate accounts as necessary.
• Answers patients' questions regarding statements and insurance coverage, answers telephone in a prompt, courteous, and helpful manner.
• Responds to all inquiries received from patients and payors either by telephone or written request
• Establishes and maintains contacts with payor accounts’ representatives.
• Reviews accounts receivable activities and calls on outstanding balances or claims.
• Processes patient refunds as needed.
• Handles transactions necessary on discharged patients.
• Completes and files all necessary paperwork for services rendered, i.e., charge tickets, patient forms, medical records, etc.
• Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service.
• Performs other duties that may be necessary or in the best interest of the organization.

Skills

medical billing

accounts receivable

data entry

English

communication

HIPAA

Tools

Microsoft Excel

Microsoft Word

Outlook

Job description

U.S. Dermatology Partners is seeking an accounts receivable specialist to manage medical billing for insurance payors and patients, maximizing collections. The role liaises between practices, clinics, the business office, payors, and patients, and requires handling calls, maintaining accurate AR status, and upholding confidentiality.

The position emphasizes following approved processes, adherence to HIPAA, and ensuring high-quality customer service while supporting KPI targets.