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AR Follow Up and Denials Specialist

Billing | Austin, TX (Frontera Crossing) | Full Time

Job Description

SCOPE

The AR Follow-up and Denials Specialist is responsible for collecting payments for outstanding claims, researching denials, submitting appeals and ensuring payments received are reconciled correctly.

ESSENTIAL FUNCTIONS

  • Collect payments for outstanding claims and ensure payments received are reconciled correctly
  • Research denials and submit appeals
  • Maintain knowledge of current government and carrier regulations relevant to the industry
  • Accurately and efficiently generate and format reports
  • Communicate clearly and professionally, in both written and verbal manners with internal personnel, payors, providers, patients and other authorized representatives in regards to outstanding balances
  • Identify and report trends in carrier payments and denials, which includes documentation of actions taken to resolve issues
  • Review and take appropriate action against correspondence (including EOBs, RAs, denial letters) within a timely manner
  • Responsible for all aspects of follow up and collections on accounts. This includes making outbound calls to payers and accessing payer websites.

 OTHER FUNCTIONS

  • This is not a comprehensive listing of activities, duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time with or without notice.

Supervisory Duties: No

KNOWLEDGE, SKILLS AND ABILITIES

  • High school diploma or GED required.
  • One-year experience with appeal submissions and/or accredited 4-year college degree and/or medical billing/coding certificate
  • An overall understanding of the appeals process through completion
  • Exemplary customer service skills
  • Attention to detail and ability to complete the job with minimal errors
  • Excellent oral and written communication skills
  • Ability to prioritize and manage time effectively
  • Ability to maintain confidentiality
  • Proficient with Microsoft Office: Word, Excel, and Outlook
  • Knowledge of HIPPA guidelines
  • Ability to read/interpret EOBs

Preferred Qualifications:

  • Strong research and problem solving abilities

WORKING CONDITIONS

  • The employee will work in a standard office environment with repetitive use of a keyboard at a workstation. The employee may occasionally lift and/or move up to approximately 10 pounds. The noise level in the work environment is usually low to moderate.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform functions.