Insurance & Patient AR Specialist

Health Texas Medical Group • San Antonio, TX

116d

About The Position

The Insurance & Patient AR Specialist is tasked with overseeing all aspects of medical accounts receivable collections for a physician medical group. They hold responsibility for following up on claim denials from all assigned insurance payers, resolving billing issues, and addressing inquiries from patients and clinic staff. Utilizing effective collection techniques, the Billing Specialist ensures that accounts receivable remain current, actively monitoring for delinquent payments and taking appropriate actions to rectify such instances. In addition, you will be responsible for contributing to the growth and success of HealthTexas while upholding our Mission, Vision and Values.

Requirements

• 2+ years medical billing and/or collections experience in a physician's or other medical facility setting.
• Must be able to multi-task, meet deadlines and be a team player.
• High School Diploma or GED.
• Completion of a recognized course of study for billing and coding is preferred.

Nice To Haves

• Knowledge of governmental insurance plans (Medicare Part B and C, Medicaid and associated advantage plans, Tricare, etc.) and commercial insurances (PPO, HMO, EPO, HRA, etc.).
• Working knowledge of CPT, HCPCS, and ICD-10.
• Understanding of HIPPA guidelines.
• Working knowledge of Word, Excel, and Outlook.
• Experience with EMR software (eClinicalWorks preferred, but not required).

Responsibilities

• Follows up on insurance billing to ensure prompt receipt of payments.
• Demonstrates professionalism in interactions with patients and insurance companies regarding sensitive financial matters, actively working to recapture unpaid balances.
• Receives and resolves patient billing inquiries promptly, initiating adjustment requests as necessary to address any discrepancies.
• Proactively follows up on all zero payment explanations of benefits, exploring all available options to obtain claim payments.
• Conducts monthly reviews of assigned accounts, identifying inconsistencies and correcting errors as needed, ensuring accuracy.
• Provides comprehensive support for inquiries related to accounts, offering assistance and guidance to stakeholders.
• Conducts thorough research on billing issues and follows up with all relevant parties to achieve resolution.
• Initiates payer and/or patient refund requests for overpayments after conducting necessary research to validate the refund eligibility.
• Initiates debt write-off requests in accordance with established policies and procedures, adhering to regulatory guidelines.
• Other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED
• Number of Employees: 101-250 employees