Medical Insurance AR Specialist Job Opening

Position Summary:

• The Medical Insurance AR Specialist is a key member and contributor to the success of the Legacy Consulting Services. This “attention to detail” position provides in-depth support for all insurance accounts receivable duties.
• This position is responsible for working complex insurance claims including rejections, denials and unresolved claims by statusing claims online, calling insurance companies, case managers, adjusters and/or employers.
• Meeting daily and weekly account goals requires efficient and effective ongoing communications with insurance carriers.
• Great interpersonal skills and teamwork abilities are required to build rapport with the team members, staff and insurance carriers.

Responsibilities:

• Responsible for thorough and exhaustive communications to insurance companies to quickly resolve unpaid Medical claims.
• Ensures all insurance related duties are completed in a timely and accurate manner to ensure excellent patient relations and financial success for the Practice.
• Achieves collections goals by effectively managing accounts receivable, prioritizing account reviews and utilizing time management skills.
• Manages and assists team members as needed with payment and insurance processes
• Responsible for accurately working Insurance AR accounts and exhausting all efforts when working an account.
• Performs critical thinking to accurately diagnose account issues and resolve claims timely.
• Prioritizes daily workload to efficiently work claims based on $ amount and timely filing deadlines.
• Ensures all claims are working prior to payor timely filing deadlines are hit.
• Performs root cause analysis across multiple claims issues and various payors to ensure timely resolution for patients.
• Serves as a liaison between insurance carriers, staff and patients to resolve any concerns.
• Maintains a positive attitude with co-workers, clients, patients and insurance companies.
• Facilitate resolution of accounts by working with the Medical office to obtain necessary information in a timely manner
• Understands Medical terminology, explanation of benefits, Medical billing protocols and coding importance.
• Exhibits good working knowledge of Excel for reporting, productivity tracking, etc.
• Treats confidentiality of patient data and client information with utmost importance.
• Other duties as required.

Qualifications and Education Requirements

• Minimum of three years’ Medical collections experience. This must include insurance claim submission in a Medical setting.
• Training/education may be substituted for some of the experience.
• Experience reading and interpreting Medical EOB's.
• Demonstrated knowledge of ICD9/ICD10 and CPT codes.
• Knowledge of PPO, Medicaid and managed care plans.
• Detail-oriented, independent thinker with critical thinking skills is a must.

Job Type: Full-time

Experience:

• Excel: 3 years (Preferred)
• medical billing and collections: 3 years (Preferred)