AR / Denials Specialist

Summit Spine and Joint Centers•Lawrenceville, GA

20h

About The Position

Summit Spine and Joint Centers is a rapidly expanding Pain Management Group looking to add an experienced Accounts Receivable / Denials Specialist to our team. With fifteen ambulatory surgery centers and thirty-one clinic locations across Georgia, Summit Spine is winning the race to become the largest comprehensive spine and joint care provider in the state of Georgia We are looking for a motivated and hard-working AR / Denials Specialist who can join our growing team of professionals.

Requirements

Minimum of 3 years’ experience with accounts receivable or revenue cycle in a medical setting
Experience with Medicare, Medicaid, Commercial insurance plans, Workers’ comp, and Personal Injury cases
Knowledge of claims submission of office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management
Knowledge of medical billing rules, such as coordination of benefits, modifiers, and understanding of EOBs and ANSI code denials.
Excellent knowledge of CPT coding, ICD.10 coding and medical pre-certification protocols required
Excellent computer skills and familiarity with Microsoft Office
Comfortable working in a growing, dynamic organization and able to navigate change.
Self-motivated with ability to multi-task, prioritize work in a fast-paced, team environment

Nice To Haves

Bachelor’s degree preferred
Experience using eClinicalWorks preferred
Experience with Pain Management preferred
The ideal candidate will be located in Georgia and able to be present at our administrative office, or near Austin, Texas where a subset of the billing team are located.

Responsibilities

Processes assigned AR, working to maximize collections while minimizing aging AR
Process insurance denials and appeals to ensure timely account resolution
Identify denial trends and provide management with a summary of identified issues
Manages outstanding accounts to include following up with insurance carriers for overpayments, underpayments, filing corrected claims, appealing claims, and following up on all denials to ensure processing / reprocessing and timely payments
Review AR aging to ensure timely collection of payments
Review and initiate payor and patient refunds
Appropriately documents issues, sources, and actions taken on each account
Identify, document, and report payer denial trends to billing manager for escalated follow-up
Creates reports regarding the status of patient accounts as requested
Address inquiries from insurance companies, patients, and providers
Ensure claim information is complete and accurate
Post office paper zero pay denials, and scan into our system
Verify patient benefits and eligibility
Maintain denials productivity spreadsheet
Follows HIPAA guidelines in handling patient information