Medical Billing AR Specialist

Job Description – Medical Billing AR Specialist

Classification – FSLA - Non-Exempt - hourly

Salary Grade/Level/Range

Level of experience, longevity, within current company pay structure.

Reports to 

Revenue Cycle Manager

Summary/Objective 

Medical Billing AR Specialists perform analysis of patient clinical and billing data to identify documentation, coding and charging opportunities. Works pre-bill edits and post adjudication denials to secure claim resolution.

Essential Functions

• Responsible for working pre-bill edits including but not limited to CCI edits and claim scrubber edits. Collaborates with intra-departmental teams to determine root cause.
• Performs denial investigation and corrections to secure claim payment.
• Identifies opportunities for denial prevention through revenue cycle.
• Maintains an understanding of regulatory and payer changes to ensure correct charging and billing requirements are met.
• Maintains working knowledge of coding and billing regulations for all payors. Keeps current on regulatory updates, local payer policies and procedures to ensure charge accuracy, compliance and optimization.
• Contact patients in order to obtain or relay billing account information.
• Field questions from patients, clerical staff, and others.
• Cooperating with the billing manager to ensure that their work adheres to the standards, guidelines, procedures, and deadlines set by the company.

Qualities and Characteristics

• Maintains a professional relationship and positive attitude with co-workers, patients and all M.I.N.D staff.
• Strives to learn more and receptive to new challenges and opportunities.
• Displays enthusiasm toward the work and the mission of M.I.N.D. 

Qualifications

• Must possess a demonstrated knowledge of clinical processes, clinical coding (CPT, ICD-10, revenue codes and modifiers), charging processes and audits, and clinical billing as normally obtained through a certified medical billing program.
• 1+ years or recent experience in high volume medical billing.
• Knowledge of ICD-10 and CPT coding, charge capture, reconciliation, error management operations and overall revenue cycle operations required.
• Working knowledge of third-party payer rules and requirements, computer operations and electronic interfaces related to charge documentation, capture and billing is required.
• Exceptional organizational skills and ability to prioritize and manage multiple functions and responsibilities simultaneously.
• Problem solving, time management and exceptional interpersonal skills.
• Good written and verbal communication skills.

Work Environment
This job operates in a medical office facility. 

Physical Demands

This position requires the ability to sit for long periods of time, view computer screens for long period of time, answering calls on a multi-line phone system, writing, reading and note taking.    

Position Type/Expected Hours of Work
This is a full-time position. Days and hours of work are Monday through Friday, varying hours between 8:00 a.m. to 4:30 p.m. 

• Travel – none

Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Employees should adhere to all approved policies, procedures and philosophies.