Medical AR Specialist — Growth & Impact in Billing

Talentify; Riverside (CA); On-site; USD 45,000 - 60,000; Full time

Benefits offered by this job

Challenging work

Growth opportunities

Competitive compensation

Job summary

Riverside Medical Clinic is seeking a claims billing specialist to accurately process fee-for-service claims and manage account collections. You will work under supervision to review tracer claims, initiate appeals, and ensure timely submissions.

You will analyze denied claims, communicate with insurers, stay current with billing regulations, and document all interactions. This role requires organizational skills and attention to detail in a mission-driven hospital setting.

Qualifications

• High school diploma and knowledge of medical terminology.
• Two years or more in medical billing/collections is required.
• Strong attention to detail and accuracy in coding and posting payments.

Responsibilities

• Assist the supervisor as requested.
• Review, adjust, and mail out all assigned tracer claims.
• Initiate claim review and/or appeals as indicated on assigned Explanation of Benefits.
• Review, adjust, and process all assigned correspondence.
• Work aging AR: contact insurer to check status; verify benefits and coverage; initiate adjustments or refunds.
• Analyze and investigate denied claims to determine root causes, including coding errors and missing information.
• Prepare and submit appeals for denied claims with payer requirements in mind.
• Resubmit corrected claims with documentation and follow up for timely processing.
• Communicate with insurance companies and payers to resolve denials and gather information for appeals.
• Maintain regular follow-up on appealed claims and escalate as needed to resolve.
• Stay informed about billing regulations and payer policies to ensure compliance.
• Manage and resolve claims with pending responses and track unpaid claims.
• Document all interactions and actions taken.
• Maintain professional attitude in performance and appearance.

Skills

Medical terminology

Billing/collections

Attention to detail

Education

High school diploma

Job description

Riverside Medical Clinic is seeking a claims billing specialist to accurately process fee-for-service claims and manage account collections. You will work under supervision to review tracer claims, initiate appeals, and ensure timely submissions.

You will analyze denied claims, communicate with insurers, stay current with billing regulations, and document all interactions. This role requires organizational skills and attention to detail in a mission-driven hospital setting.