Medical Billing AR Specialist

Job Description - Medical Billing AR Specialist

Classification - FSLA - Non-Exempt - hourly

Salary Grade / Level / Range

Level of experience, longevity, within current company pay structure.

Reports to

Revenue Cycle Manager

Summary / Objective

Medical Billing AR Specialists perform analysis of patient clinical and billing data to identify documentation, coding and charging opportunities. Works pre-bill edits and post adjudication denials to secure claim resolution.

Essential Functions

• Responsible for working pre-bill edits including but not limited to CCI edits and claim scrubber edits. Collaborates with intra-departmental teams to determine root cause.
• Performs denial investigation and corrections to secure claim payment.
• Identifies opportunities for denial prevention through revenue cycle.
• Maintains an understanding of regulatory and payer changes to ensure correct charging and billing requirements are met.
• Maintains working knowledge of coding and billing regulations for all payors. Keeps current on regulatory updates, local payer policies and procedures to ensure charge accuracy, compliance and optimization.
• Contact patients in order to obtain or relay billing account information.
• Field questions from patients, clerical staff, and others.
• Cooperating with the billing manager to ensure that their work adheres to the standards, guidelines, procedures, and deadlines set by the company.

Qualities and Characteristics

Qualifications

Work Environment This job operates in a medical office facility.

Physical Demands

This position requires the ability to sit for long periods of time, view computer screens for long period of time, answering calls on a multi-line phone system, writing, reading and note taking.

Position Type / Expected Hours of Work This is a full-time position. Days and hours of work are Monday through Friday, varying hours between 8 : 00 a.m. to 4 : 30 p.m.

Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Employees should adhere to all approved policies, procedures and philosophies.