Job Summary
We are seeking a proactive and detail-oriented AR Follow-up and Denial Specialist to join our dynamic healthcare billing team. In this role, you will be responsible for managing accounts receivable by following up on unpaid claims, resolving claim denials, and ensuring timely reimbursement from insurance companies and patients. Your expertise will help optimize revenue cycle processes, reduce outstanding balances, and improve overall cash flow. The ideal candidate is passionate about healthcare finance, possesses strong communication skills, and thrives in a fast-paced environment dedicated to accuracy and efficiency.
Responsibilities
- Monitor and follow up on unpaid or partially paid insurance claims within designated timeframes to ensure prompt resolution.
- Review denied claims to identify reasons for denials, such as coding errors or documentation issues, and take corrective actions to resubmit or appeal as needed.
- Analyze claim rejections related to DRG (Diagnosis-Related Group), CPT (Current Procedural Terminology) codes, ICD-9, ICD-10, and ICD coding discrepancies to facilitate accurate reimbursement.
- Collaborate with clinic teams and coding teams to verify medical records, ensure proper documentation, and resolve discrepancies impacting claim payments.
- Maintain detailed records of all follow-up activities, appeals, and correspondence with payers and patients in EMR (Electronic Medical Records) or EHR (Electronic Health Records) systems.
- Communicate effectively with insurance companies, healthcare providers, and patients to clarify information and expedite resolution of outstanding balances.
- Stay updated on industry regulations, payer policies, and coding guidelines to ensure compliance and maximize reimbursement opportunities.
Skills
- Strong knowledge of medical billing processes and collection strategies within a healthcare setting.
- Proficiency in medical coding including DRG, CPT coding, ICD-9, ICD-10, and ICD coding systems.
- Experience working with EMR/EHR systems for documentation management and claim tracking.
- Excellent understanding of medical terminology and medical records review procedures.
- Ability to analyze complex claims data to identify issues related to denials or underpayment.
- Effective communication skills for liaising with payers, providers, and patients professionally.
- Provide education to team members on payer policies and denial prevention.
- Detail-oriented with strong organizational skills to manage multiple accounts simultaneously while maintaining accuracy. Join us in making a difference by ensuring our healthcare revenue cycle runs smoothly! Your dedication will directly impact patient care by supporting the financial health of our organization through diligent follow-up and expert denial management.
Please include desired salary with resume submission.
Job Type: Full-time
Pay: $18.00 - $24.50 per hour
Expected hours: 40.0 per week
Benefits:
- 401(k)
- Dental insurance
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance
Application Question(s):
Experience:
- Medical billing: 2 years (Preferred)
Work Location: Hybrid remote in Virginia Beach, VA 23462
