A/R Specialist I

Inspire Health Medical Group•Fresno, CA

About The Position

JOB PURPOSE: The AR Specialist I position is responsible to obtain medical eligibility information ensuring that the most updated insurance is entered into the practice management system, obtain authorizations, and assist patients with their account inquiries, routing and advancing calls as needed.

Requirements

High school diploma or equivalent
Minimum one (1) to two (2) years experience using a computerized accounts receivable system in a medical or hospital setting performing billing functions.
Minimum one (1) year of experience utilizing insurance payer portals
Experience in handling confidential data, patient demographic information
Knowledge of medical insurance and authorization processes
Maintain up to date knowledge of insurance policies
Ability to pass Billing Department testing at 70%.
Basic Microsoft Excel and Word knowledge
Basic CPT-4 and ICD-10 coding knowledge preferred.
Analytical with attention to detail
Excellent customer service skills
Excellent organization and time management skills
Strong verbal and written communication
Bilingual preferred
Ability to remain focused and productive as tasks may be repetitive
Ability to effectively work and communicate with coworkers, patients, and outside agencies
Ability to prioritize and manage multiple tasks
Ability to work effectively in a fast, team-based environment

Responsibilities

Research eligibility information with various insurance carriers.
Responsible for obtaining or validating referrals and authorizations for procedures and services, as required
Responsible for ensuring billed charges are allowable per payer policies.
Accurate verification of all insurance benefits, and entry of new or updated insurance information for all patient accounts
Responsible for outreach to patients or payers to validate incomplete insurance information
Assist with customer service calls
Retrieve supporting documentation and other data from all facilities for accurate and timely processing of claims
Manage the worklist assignment for eligibility holds within practice management system
Manage collection assignment worklists in the practice management system.
Participate in internal audit requests
Possess understanding of EOB nomenclature
Open, process, and distribute inbound correspondence
Meet department standards for production and quality
Assist in the development and ongoing assessment of policies and procedures
Identify and communicate problems to team members and management
Attend monthly meetings to keep abreast of policy changes and billing department concerns
Other duties as assigned