Oral Surgery AR Specialist: Claims & Denial Resolution

HighFive Healthcare; Birmingham (AL); On-site; USD 36,000 - 60,000; Full time

Job summary

HighFive Healthcare is seeking an Accounts Receivable Specialist to manage the Oral Surgery insurance AR process, submit claims timely, and follow up on denials. The role collaborates with payors and patients to resolve billing discrepancies.

Experience in denial management and healthcare billing is required. Ideal candidates have 2+ years in healthcare billing, familiarity with EHR systems, and strong attention to detail.

Qualifications

• Oral Surgery billing experience required.
• Denial/Claim or AR experience with TMJ or related procedures preferred.
• Minimum of 2 years of healthcare billing and accounts receivable.
• Knowledge of medical insurance plans, billing procedures, and reimbursement processes.
• Proficiency with EHR systems and billing software.
• Working knowledge of Excel and system workflows.
• Strong attention to detail and accuracy in claims processing.
• Excellent communication and problem-solving skills.

Responsibilities

• Investigate, appeal, and resolve denied or rejected claims by insurance payors.
• Review and assess EOBs to determine issues at the claim level.
• Determine root cause of billing issues to prevent recurrence.
• Make corrections to claims and rebill using standardized processes.
• Follow up with unresolved claims via system resources, clearinghouse, payer portal, or calls.
• Assess if an appeal is required and track appeals for timely payment.
• Spot recurring denial patterns and report to management.
• Communicate effectively with team members, payors, patients, and others.
• Stay updated on internal processes, industry standards, and regulations.
• Participate in special projects or additional duties as needed.
• Meet or exceed daily accounts to satisfy HighFive and provider expectations.
• Contribute to net collection rate goals and resolution of denied claims.

Skills

Oral Surgery billing

Denial management

EHR systems

Billing software

HIPAA compliance

Excel

Communication skills

Independent work

Problem solving

Education

High school diploma

Healthcare/business degree preferred

Tools

Billing software

Job description

HighFive Healthcare is seeking an Accounts Receivable Specialist to manage the Oral Surgery insurance AR process, submit claims timely, and follow up on denials. The role collaborates with payors and patients to resolve billing discrepancies.

Experience in denial management and healthcare billing is required. Ideal candidates have 2+ years in healthcare billing, familiarity with EHR systems, and strong attention to detail.