Job Description

Our client is seeking an experienced Medical Accounts Receivable (AR) Specialist to manage all aspects of medical AR collections for a physician medical group. This role will focus heavily on insurance claim denial follow-up, unpaid claims, payment recovery, billing issue resolution, and account management. 

Key Responsibilities

• Manage assigned medical accounts receivable and insurance payer follow-up to ensure timely payment of outstanding claims.
• Perform claim denial follow-up, research unpaid and underpaid claims, identify billing issues, and pursue available options to obtain payment.
• Follow up on zero-payment Explanation of Benefits (EOBs) and determine appropriate next steps for claim resolution.
• Monitor accounts for delinquent payments and use appropriate collection techniques to maintain current AR.
• Research and resolve patient billing inquiries, insurance issues, and account discrepancies.
• Professionally communicate with patients, insurance companies, and clinic staff regarding account balances, claims, payments, and billing concerns.

Required Qualifications

• High School Diploma or GED.
• 2+ years of medical billing and/or collections experience, preferably within a physician practice, medical group, hospital, or other healthcare setting.
• Knowledge of government insurance programs, including Medicare Part B and C, Medicaid and associated Medicare Advantage plans, and TRICARE.
• Knowledge of commercial insurance plans, including PPO, HMO, EPO, and HRA.
• Working knowledge of CPT, HCPCS, and ICD-10 coding.
• Understanding of HIPAA guidelines and the importance of protecting patient information.