*Insurance AR Specialist*

Overview

As an Insurance A/R Specialist, you'll collect payments for an assigned segment of the insurance accounts receivable and performs insurance follow up duties in accordance with established federal and state regulations. You'll also appeal claim denials as necessary and appropriate.

Responsibilities

• Follows-up with insurance companies and ensures claims are paid/processed
• Services each account in priority of importance and independently billing accounts with understanding of all applicable insurance and/or CMS regulations
• Resubmits insurance claims that have received no response or are not on file, in a timely manner according to each insurance’s contracted filing limits
• Reviews and appeals unpaid and denied claims, includes analysis of coding that assures proper billing
• Makes changes to demographic information as necessary in order to produce a clean claim
• Researches and prepares insurance credits for refund approval
• Maintains an error rate in accordance with departmental policy
• Performs all other assigned duties
• Please note this role is onsite Monday-Friday

Qualifications

• High School diploma or equivalent
• 2 years medical billing experience
• Ophthalmology background desired
• Active knowledge of CMS guidelines, contracted insurance guidelines and coding policies
• Demonstrates computer literacy
• Well-organized with attention to detail
• Ability to read and understand oral and written instructions
• Excellent math skills
• Ability to establish and maintain effective working relationship with team members, clinic staff, payers and patients
• Professional customer service skills
• Has a desire and dedication to work with self-discipline