AR Specialist (Full-Time)

The AR Specialist is a multi-tasking highly skilled position that encompasses all key functions of physician billing. The AR Specialist position requires an advanced revenue cycle knowledge that has been acquired through experience and developed through training and education. The AR Specialist supports patient-centered care and Customer Service by serving as a patient advocate during the life cycle of the account. Under direct supervision, the AR Specialist is expected to maintain productivity, accountability, and produce very efficient and proficient results.

The AR Specialist is a highly motivated individual with a proven ability to manage multiple tasks. The AR Specialist will possess extensive knowledge of medical billing processes focusing on OB/GYN billing and insurance denials and be proficient in medical terminology, coding, and billing systems. The AR Specialist will manage telephone calls from patients, insurance companies, and medical practices to answer inquiries, follow up on outstanding claims, and update accounts as required. The AR Specialist will possess exceptional organizational skills, a mature, pleasant, and professional telephone manner, and the ability to prioritize work. The AR Specialist ensures that the aging Accounts Receivable (AR) is kept current and that all denials are researched and updated. The AR Specialist will respond effectively to sensitive inquiries or patient complaints to Diana Health's patient population.

• →Utilize expertise in OB/GYN billing processes to investigate and resolve insurance denials through
  effective communication with payers and attention to detail in claim resubmissions
• →Navigate various payer portals to monitor claim status and eligibility and resolve issues promptly
• →Collaborate with internal teams to gather and provide necessary appeals and claims processing
  documentation
• →Maintain up-to-date knowledge of medical billing regulations and compliance requirements
• →Utilize medical collection practices and procedures to manage outstanding accounts receivable
• →Ensure accuracy in data entry and record-keeping for billing-related activities
• →Prioritize tasks effectively to meet deadlines and achieve goals

• Complies with Revenue Cycle policies and procedures
• Works assigned task lists, work queues, work files and reports
• Maintains current knowledge of third-party payor reimbursements and managed care contracts
• Maintains knowledge and is familiar with physician billing, accounts receivable, and EHR systems
• Utilizes and identifies all components of Explanation of Benefits (EOB)/Explanation of Payments (EOP)
• Accurately counts and tracks all daily activities and production
• Completes and accurately documents activity or communication on accounts
• Meets department production standards consistently as defined by department management
• Works special projects as assigned by Manager, Supervisor, or others

• Skill and ability to communicate effectively both verbally and in-writing
• Ability to read and comprehend simple instructions, short correspondences, and memos
• Ability to write
  simple correspondence
• Ability to effectively present information in one-on-one and small group
  situations to customers, clients, and other employees of the organization

• Adds, subtracts, multiplies, and divides in all units of measure, using whole numbers, common fractions,
  and decimals
• Ability to understand and calculate figures and amounts such as simple discounts, interests, and
  percentage measures and to read tabular and bar graphs

• Skill and ability in Physician Billing Systems (PB), Electronic Medical Records (EMR), and Microsoft
  Office applications with working usage of MS Word, Outlook, and Excel
• Extensive knowledge on use of email, search engines, Internet, and ability to effectively use payor
  websites and portals
• Requires proficiency with various healthcare computer system applications that are used by physicians
  in the office and in hospital settings to support patient care, billing, and financial information.

• Ability to advocate on patient’s behalf, listen to patient concerns attentively, and address patient matters
  promptly, courteously, and respectfully.

• High school diploma or GED required
• 3 to 5 years of experience in medical claims collection and be familiar with aging reports, delinquent claims reports, correspondence, EOBs, and other sources of information.
• Demonstrated ability to be detail oriented with strong aptitude for accuracy required
• Demonstrated ability to effectively work with others required
• Knowledge of proper business writing standards for letters and memos including the ability to write a correspondence with proper punctuation, grammar, spelling, etc
• Proven effective verbal, listening and written communications skills

• Having a growth mindset and striving for continuous learning and improvement
• Positive, can do / how can I help attitude
• Empathy for our team and our clients
• Taking ownership and driving to results
• Being scrappy and resourceful