Overview
A high-growth network of modern women's health practices is seeking an Accounts Receivable (AR) Specialist with advanced revenue cycle knowledge, particularly in OB/GYN billing. This role supports patient-centered care by serving as a patient advocate throughout the account lifecycle, managing billing processes, insurance denials, and communications with patients and payers.
Responsibilities
- Investigate and resolve insurance denials related to OB/GYN billing through effective communication with payers and detailed claim resubmissions
- Monitor claim status and eligibility by navigating various payer portals and resolve issues promptly
- Collaborate with internal teams to gather and provide documentation for appeals and claims processing
- Maintain up-to-date knowledge of medical billing regulations and compliance requirements
- Manage outstanding accounts receivable using medical collection practices and procedures
- Ensure accuracy in data entry and record-keeping for billing activities
- Prioritize tasks to meet deadlines and departmental goals
- Comply with revenue cycle policies and procedures
- Work assigned task lists, work queues, work files, and reports
- Maintain knowledge of third-party payor reimbursements and managed care contracts
- Utilize and interpret Explanation of Benefits (EOB) and Explanation of Payments (EOP)
- Accurately track daily activities and production
- Document all account activities and communications thoroughly
- Meet department production standards consistently
- Participate in special projects as assigned by management
Knowledge, Skills, and Abilities
Language/Communication Skills
- Effective verbal and written communication skills
- Ability to read and comprehend instructions, correspondences, and memos
- Ability to write simple correspondence with proper grammar and punctuation
- Present information effectively in one-on-one and small group settings
Mathematical Skills
- Perform basic arithmetic operations including addition, subtraction, multiplication, and division
- Understand and calculate figures such as discounts, interest, and percentages
- Interpret tabular and bar graphs
Computer/Technical Skills
- Proficiency with Physician Billing Systems, Electronic Medical Records (EMR), and Microsoft Office applications (Word, Outlook, Excel)
- Skilled in using email, internet search engines, and payer websites/portals
- Familiarity with healthcare computer systems supporting patient care, billing, and financial information
Customer Service Skills
- Advocate on behalf of patients, listen attentively to concerns, and address matters promptly, courteously, and respectfully
Qualifications
- High school diploma or GED required
- 3 to 5 years of experience in medical claims collection, including familiarity with aging reports, delinquent claims reports, correspondence, and EOBs
- Detail-oriented with strong accuracy skills
- Ability to work effectively with others
- Knowledge of proper business writing standards
- Proven verbal, listening, and written communication skills
Compensation and Benefits
- Competitive compensation
- Health, dental, and vision insurance with HSA/FSA options
- 401(k) plan with employer match
- Paid time off
- Paid parental leave
Location
This position is based within the organization's network of women's health practices. Specific location details will be provided during the hiring process.