AR Spec

Job Responsibilities

• Resolves payer requests for additional information by submitting itemized bills medical records EOBs and any other necessary documentation to get claim paid.
• Promptly resolves eligibility and coordination of benefits denials by identifying and updating insurance information and ensuring claim is rebilled to correct payer immediately.
• Ability to use network computer software.
• Works with payers on unprocessed (not paid or denied) claims to ensure payment is forthcoming in a timely manner and promptly escalates unresolved issues to appropriate parties at insurance company.
• Provides feedback to supervisor and ensures collecting the information of trends and responds to inquiries about trends.
• Performs any necessary account adjustments in accordance with department policies.
• Ensures assigned work queues are reviewed and resolved timely.
• Monitors assigned work queues and payers for identification of potential problems.
• Other duties as assigned.

Education Requirements

• Minimum: High School Diploma or equivalent
• Preferred: Medical Certification program in healthcare

Experience Requirements

• Minimum: Six (6) months or more experience within a hospital and/or medical billing office.
• Preferred: A healthcare background working in medical billing collections insurance claims processing coding registration or working in a hospital business office.

Licenses/Certifications

• Minimum: None