Medical Billing AR / Denials Specialist

Summit Spine and Joint Centers
Lawrenceville, GA

Quick Apply

Job Details

Full-time

Benefits

Health insurance
Paid time off
401(k) matching

Qualifications

Workers' compensation insurance knowledge
Medical coding experience in outpatient clinics

Full Job Description

Company Overview:

Summit Spine and Joint Centers (SSJC) is a rapidly growing, multi-state Interventional Pain Management practice providing comprehensive clinical, surgical, and imaging services. With locations across Georgia, North Carolina, South Carolina, Tennessee, Florida, and Texas, our team is committed to delivering exceptional, patient-centered care through collaboration, innovation, and clinical excellence.

As one of the largest single-specialty pain management practices in the nation, SSJC continues to expand its network while investing in the people who make our success possible. We are seeking motivated, qualified professionals who are passionate about making a meaningful impact and contributing to our continued growth.

Job Duties:

Processes assigned AR, working to maximize collections while minimizing aging AR
Process insurance denials and appeals to ensure timely account resolution
Identify denial trends and provide management with a summary of identified issues
Manages outstanding accounts to include following up with insurance carriers for overpayments, underpayments, filing corrected claims, appealing claims, and following up on all denials to ensure processing / reprocessing and timely payments
Review AR aging to ensure timely collection of payments
Review and initiate payor and patient refunds
Appropriately documents issues, sources, and actions taken on each account
Identify, document, and report payer denial trends to billing manager for escalated follow-up
Creates reports regarding the status of patient accounts as requested
Address inquiries from insurance companies, patients, and providers
Ensure claim information is complete and accurate
Post office paper zero pay denials, and scan into our system
Verify patient benefits and eligibility
Maintain denials productivity spreadsheet
Follows HIPAA guidelines in handling patient information

Qualifications:

Minimum of 3 years’ experience with accounts receivable or revenue cycle in a medical setting
Experience with Medicare, Medicaid, Commercial insurance plans, Workers’ comp, and Personal Injury cases
Knowledge of claims submission of office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management
Knowledge of medical billing rules, such as coordination of benefits, modifiers, and understanding of EOBs and ANSI code denials.
Excellent knowledge of CPT coding, ICD.10 coding and medical pre-certification protocols required
Excellent computer skills and familiarity with Microsoft Office
Comfortable working in a growing, dynamic organization and able to navigate change.
Self-motivated with ability to multi-task, prioritize work in a fast-paced, team environment
Bachelor’s degree preferred
Experience using eClinicalWorks preferred
Experience with Pain Management preferred

Preferred Location

While this is a remote position, preference will be given to candidates residing in one of the following states:

Georgia
Texas
North Carolina
South Carolina
Florida

Candidates located in Georgia should be able to attend meetings or training at our Lawrenceville administrative office as needed.

Compensation & Benefits

This is a full-time position offering a competitive salary, paid time off (PTO), comprehensive health benefits, and a 401(k) with company match.

Quick Apply

Company Overview:

Preferred Location

Compensation & Benefits

Job Seeker Tools

Employer Tools

Browse

Stay Connected