A/R Billing Specialist – Franklin, TN

A/R Billing Specialist – Franklin, TN

PhyNet Dermatology has an IMMEDIATE NEED for the top Billing Specialists to join our team! If that's you, we invite you to apply to today! The A/R Billing Specialist is responsible for all aspects of insurance follow up and collections, including making telephone calls and accessing payer websites.

Responsibilities:

  • Monitor commercial, government, and specialty payer claims to ensure timely follow up and claims resolution.
  • Maintain working knowledge of all payer guidelines and requirements as they relate to denials and appeals.
  • Make changes to demographic information as necessary to produce a clean claim.
  • Meet or exceed productivity standards in the completion of daily assignments and accurate production.
  • Responsible for reviewing and understanding medical records, provider notes, Explanation of Benefits, etc. for knowledge of appeal or account resolution.
  • Facilitates and initiates appeals to insurance companies for claim resolution.
  • Handles correspondence requests from payers to ensure all information that is required for claim processing is provided in a timely manner.
  • Analyze coding to ensure proper billing of claim. Experience with claims follow up, denial posting, claim processing, and appeals.
  • Adhere to quality and productivity standards assigned by management.
  • Ensure statements are generated for the patient responsibility amounts.
  • Utilize insurance websites to view and resolve claims.
  • Perform extensive account follow-up and provide analysis of problem accounts.
  • Document all follow up efforts in a clear and concise manner into the AR system.
  • Audit and research accounts, payment and contractual postings, and patient payments to confirm the accuracy of the balance of the account.
  • Ability to identify and report payer trends that may provide insight into payment challenges. Collaborate with management on difficult or reoccurring denials.
  • Phone contact with patient, physician office, insurance company, etc. for additional information to process the claim.
  • Ability to assign CPT/ICD-9/10 and HCPCS codes from surgical/progress note.
  • Attention to detail with the ability to identify/resolve problems and document the outcome.
  • Regular and reliable attendance.
  • Strong telephonic communication skills with a pleasant and friendly demeanor.

Join us if you have:

  • Denials/follow up experience REQUIRED!
  • Ability to review, comprehend, discuss HCFA billing with Insurance or Government agencies.
  • Knowledge of general insurance requirements, working denials, and submitting appeals.
  • Experience working directly with EOBs and contractual adjustments.
  • General computer knowledge, working with electronic filing.
  • Ability to communicate verbally/in writing with professionalism.
  • Ability to meet productivity expectations