Insurance A/R Specialist III

Austin Health Partners•Austin, TX

4d•Hybrid

About The Position

Insurance AR Specialists will be responsible for the management of outstanding insurance accounts through written or verbal direction from insurance carriers for the accurate and timely filing of claims for maximum reimbursement and posting rejections with accurate explanations. Insurance A/R Specialist duties include answering patient balance inquiries and providing outstanding customer service.

Requirements

High School Diploma or equivalent
Minimum of 3 years experience in revenue cycle management
Good understanding of Medicaid, Medicare and Commercial Insurance
Practice management software experience
Familiarity with CPT and ICD 10 coding, familiarity with medical terminology

Nice To Haves

Some college preferred

Responsibilities

Thoroughly research reasons for denied claims and work appeals as necessary to resolve outstanding balances
Responsible for resolving denials/appeals in the Hold bucket within 72 hours of receipt
Review previously worked claims within a minimum of 30 days
Responsible for the accurate and timely resolution of professional billing claim and clearinghouse edits as well as payer rejections
Responsible for resolving claims that are greater than 60 days from date of service
Work a minimum of 50 claims a day
Communicate effectively with the Coders to handle the accurate and timely resolution of coding- related claim edits and appeals
Identify and document new payer denial trends, and notify supervisor for escalated follow up
Manage patient and payer credit balances with established policy and procedures
Answer phone calls regarding billing inquiries and resolve billing issues in a polite and confident manner
Create collections works lists and submit for provider approval
Assist with charge entry back log
Regular & prompt attendance on agreed upon daily and weekly start and end time
Ethical conduct, confidentiality, and collaboration with the healthcare team are expected and considered essential elements of this position
Other duties as assigned
Can maintain physical demands and work environment as listed below