Claims and AR Specialist

Job Summary:

Central Dermatology Center is looking for an enthusiastic and professional individual to join our team as a Claims and AR Specialist.

This role is responsible for revenue cycle tasks related to insurance and patient billing. You must be well-versed in billing software, medical insurance regulations, and proficient at responding to patient and insurance inquiries. You will also be responsible for maintaining patient confidentiality, handling personal information, and accurately inputting patient data into a billing software system.  

Duties/Responsibilities:

• Checking eligibility and benefits verification for treatments and procedures.
• Reviewing patient bills for accuracy and completeness and obtaining any missing information.
• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
• Correcting and resubmitting rejected claims.
• Processing insurance and patient payments from electronic remittances, lockbox, mail, and payer websites.
• Following up on unpaid claims within a standard billing cycle time frame.
• Checking each insurance payment for accuracy and compliance with contract discount.
• Contacting insurance companies regarding any discrepancy in payments, if necessary.
• Identifying and billing secondary or tertiary insurances.
• Reviewing accounts and performing insurance and/or patient follow-up.
• Researching and appealing denied claims.
• Processing and responding to incoming insurance correspondence, including medical record requests.
• Answering patient or insurance inquiries pertaining to assigned accounts.
• Setting up patient payment plans and work collection accounts.
• Reporting issues and coordinating with the revenue cycle supervisor to implement necessary software and policy changes. 
• Following balancing and reconciliation procedures.
• Reviewing unallocated payments and identifying refunds.
• Running A/R and collection reports.
• Coordinating with providers to reconcile missing charges and/or unsigned charts.
• Maintaining appropriate knowledge of payer policies and requirements, including Medicare, Medicaid, other government programs, and commercial insurance carriers.
• Perform other duties as assigned.

Required Skills/Abilities:

• Strong communication skills, including writing, speaking, and active listening.
• Great customer service skills, including interpersonal communication, patience, and empathy.
• Familiarity with CPT and ICD-10 coding.
• Ability to work well in a team environment. Ability to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion.
• Good problem-solving and critical thinking skills.
• In-depth knowledge of industry best practices.
• Basic math, bookkeeping, and accounting knowledge.
• Good organization, time management, and prioritization abilities.
• Ability to be discreet and maintain the privacy and security of patient or customer information. 
• Understanding of industry-specific policies, such as HIPAA regulations for healthcare.

Education/Experience:

Required:

• High school diploma or equivalent.
• Knowledge of medical billing and accounts receivable.
• A minimum of 1-3 years of experience in a medical office setting.

Preferred:

• Associates degree. 
• Familiarity with EMA/modernizing medicine PM.
• Familiarity with dermatology billing.

Physical Requirements:

Job Relationships:

• Reports to revenue cycle supervisor.
• Works with other practice staff.

Job Type:

·       Compensation:  $18-$20 / hour based on education and experience.