Medical Billing AR/Denials Specialist

Surgical Center Solutions, LLC; Lawrenceville (GA); On-site; USD 45,000 - 60,000; Full time

Benefits offered by this job

Paid time off (PTO)

Comprehensive health benefits

401(k) with company match

Job summary

Summit Spine and Joint Centers (SSJC) is seeking a skilled Accounts Receivable/Billing professional to maximize collections and resolve denials for a multi-state pain management practice. Responsibilities include appeals, trend analysis, and ongoing AR management across payer types.

Candidates should have 3+ years in medical AR, CPT/ICD-10 proficiency, and familiarity with eClinicalWorks or similar systems. This full-time role requires in-office presence in Georgia with competitive benefits.

Qualifications

• Minimum of 3 years’ experience with accounts receivable or revenue cycle in a medical setting.
• Experience with Medicare, Medicaid, Commercial insurance plans, Workers’ comp, and Personal Injury cases.
• Knowledge of CPT coding, ICD.10 coding and medical pre-certification protocols.

Responsibilities

• Process AR to maximize collections and minimize aging AR.
• Process insurance denials and appeals to ensure timely resolution.
• Identify denial trends and report findings to billing manager.
• Follow up with insurers for overpayments, underpayments, and appeals.
• Review AR aging to ensure timely collection of payments.
• Review and initiate payor and patient refunds.
• Document issues, sources, and actions taken on each account.
• Create reports on the status of patient accounts as requested.

Skills

Accounts Receivable

Medicare/Medicaid

CPT coding

ICD-10 coding

Microsoft Office

Medical billing software

eClinicalWorks

Tools

eClinicalWorks

Job description

• Employee Type FT Exempt
• Required Degree NONE

Description

Company Overview:

Summit Spine and Joint Centers (SSJC) is a rapidly growing, multi-state Interventional Pain Management practice providing comprehensive clinical, surgical, and imaging services. With locations across Georgia, North Carolina, South Carolina, Tennessee, Florida, and Texas, our team is committed to delivering exceptional, patient-centered care through collaboration, innovation, and clinical excellence.

As one of the largest single-specialty pain management practices in the nation, SSJC continues to expand its network while investing in the people who make our success possible. We areseekingmotivated, qualified professionals who are passionate about making a meaningful impact and contributing to our continued growth.

Job Duties:

Processes assigned AR, working to maximize collections while minimizing aging AR

Process insurance denials and appeals to ensuretimelyaccount resolution

Identifydenial trends and provide management with a summary of identified issues

Manages outstanding accounts to include following up with insurance carriers for overpayments, underpayments, filing corrected claims, appealing claims, and following up on all denials to ensure processing / reprocessing andtimelypayments

Review AR aging to ensuretimelycollection of payments

Review andinitiatepayor and patient refunds

Appropriately documents issues, sources, and actions taken on each account

Identify, document, and report payer denial trends to billing manager for escalated follow-up

Creates reportsregardingthe status of patient accounts as requested

Address inquiries from insurance companies, patients, and providers

Ensure claim information is complete andaccurate

Post office paper zero pay denials, and scan into our system

Verify patient benefits and eligibility

Qualifications:

Minimum of 3 years’ experience with accounts receivable or revenue cycle in a medical setting

Experience with Medicare, Medicaid, Commercial insurance plans, Workers’ comp, and Personal Injury cases

Knowledge of claims submission of office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management

Knowledge of medical billing rules, such as coordination of benefits, modifiers, and understanding of EOBs and ANSI code denials.

Excellent knowledge of CPT coding, ICD.10 coding and medical pre-certification protocolsrequired

Excellent computer skills and familiarity with Microsoft Office

Comfortable working in a growing, dynamic organization and able to navigate change.

Self-motivated with ability to multi-task, prioritize work in a fast-paced, team environment

Experience using eClinicalWorks preferred

Experience with Pain Management preferred

Preferred Location:

Georgia

Texas

North Carolina

South Carolina

Florida

Candidateslocatedin Georgia should be able to attend meetings or training at our Lawrenceville administrative office as needed.

This is a full-time position offering a competitive salary, paid time off (PTO), comprehensive health benefits, and a 401(k) with company match.

The employee must communicate professionally, respectfully, and effectively with patients, visitors, clinicians, coworkers, and vendors, including in busy, demanding, or stressful circumstances. The employee mustmaintainprofessional composure and consistently perform assigned duties throughout the scheduled work period; manage routine workplace stressors and feedback without disrupting patient care, patient-facing operations, or coworkers’ work; and use established de-escalation and escalation procedures whenappropriate. The employee must exercise sound judgment;maintainappropriate workplaceboundaries; receive and respond to routine feedback and direction; protect confidential patient and business information; and address patient or workplace concerns through established supervisory and safety procedures. These functions are essential to the position.