AR Specialist- Revenue Cycle Management

Gryphon Healthcare•Houston, TX

8d•Onsite

About The Position

The Account Receivable Specialist submits claims, appeals denied claims, and works with commercial insurance carriers to secure prompt and accurate payment. The role monitors and follows up on claims, corrects and resubmits claims as needed, tracks communication and payment issues, and identifies billing trends. This is an onsite position at Gryphon Healthcare’s corporate office in Houston, Texas, scheduled for 40 hours per week.

Requirements

High school diploma or equivalent.
Two years of medical billing experience preferred.
Knowledge of medical billing and collection practices.
Knowledge of regulatory and payer reimbursement requirements and reasons for auditor denials.
Knowledge of basic medical coding and third-party operating procedures and practices.
Experience with EMR, EDI, commercial insurance company systems, PM systems such as Collaborate and GoRev, multiple clearinghouses, and payment systems.
Experience with out-of-network negotiations, appeals, and reconsiderations.
Ability to interpret and explain out-of-pocket expenses, EOBs, and CARC/RARC codes to patients, carriers, and other callers.
Basic computer literacy, including keyboarding, Microsoft Outlook, Teams, Excel, and Word, and the ability to navigate a Windows environment.
Understanding of basic Excel spreadsheet concepts for work queues.
Detail-oriented, with strong organizational skills and the ability to prioritize workload.
Interpersonal skills to work with all levels of the billing and management team.
Excellent oral communication, technical writing, and typing skills.
Ability to write and speak effectively in English.
Ability to flex hours as needed to meet needs related to unanticipated volume, changes, or problems.

Nice To Haves

Two years of medical billing experience.

Responsibilities

Monitor denied claims in the assigned billing system and reprocess claims with correct demographic and coding information to meet timely filing requirements through the clearinghouse.
Follow up on denied claims to ensure payment from insurance companies.
Use weekly Accounts Receivable work lists to identify unpaid claims and contact insurance carriers to reprocess or appeal them.
Initiate tracers with commercial insurance carriers to locate missing or lost payments.
Document communications from insurance companies and patients about claim status in the billing system.
Identify and communicate billing trends, including recurrent denials, to the AR Manager.
Provide support as needed to members of the billing and auxiliary departments.
Stay current on issues, trends, and changes in laws and regulations governing medical billing.
Communicate professionally with patients and insurance representatives by phone and email.
Maintain confidentiality of patient data and medical records in compliance with HIPAA guidelines and regulations.
Resolve a minimum of 30–50 claims per day.
Perform other duties as assigned.