Ar Specialist (Healthcare Account)

Verify/obtain eligibility and/or authorization utilizing payer web sites, client eligibility systems or via phone with the insurance carrier/providers.Research/Status unpaid or denied claims.Monitor claims for missing information, authorization, and control numbers (ICN/DCN).Research EOBs for payments or adjustments to resolve claims.Contact payers via phone or written correspondence to secure payment of claims; reconsideration and appeal submission.Access client systems for payment, patient, claim and data info.Follow guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems.Secure needed medical documentation required or requested by third-party insurance carriers.Maintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure.Perform other related duties as required.Minimum Requirements & Competencies: 2+ years of medical collections/billing experience.Intermediate knowledge of ICD-10, CPT, HCPCS and NCCI.Intermediate knowledge of third-party billing guidelines.Intermediate knowledge of billing claim forms (UB04/1500).Intermediate knowledge of payor contracts.Working knowledge of Microsoft Word and Excel.Intermediate working knowledge of health information systems (i.e., EMR, Claim Scrubbers, Patient Accounting Systems, etc.).Must be willing to work onsite.Preferred Requirements & Competencies: Working knowledge of one or more of the following Patient accounting systems – EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts, or Paragon.Working knowledge of DDE Medicare claim system.Knowledge of government rules and regulations.
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