AR Specialist

Florida Retina Institute - Orlando, FL

Full-time - Entry Level

Onsite - Orlando, FL

Ambulatory Health Care Services

About the position

The Accounts Receivable Specialist plays a crucial role in the financial operations of the Florida Retina Institute by ensuring the timely and accurate billing and collection of patient accounts. This position requires good judgment in evaluating patient accounts and taking appropriate actions to ensure compliance with billing practices and collections. The specialist will be responsible for performing consistent, assertive, efficient, and timely follow-ups on accounts as determined by management, maintaining minimum accounts receivable performance according to MGMA standards. The role involves assisting in increasing cash collections and decreasing accounts receivable aging for designated plans through effective collection techniques, including the use of escalation and appeal processes, as well as direct contact with patients and physicians. In addition to follow-up activities, the Accounts Receivable Specialist must possess a strong understanding of payer contracts, Remittance Advices (RA), and Explanation of Benefits (EOB) statements. Experience with Medicare, Medicaid, and third-party payers is essential, as the specialist will engage in phone follow-ups and correspondence during the appeals or denial resolution process. The role also requires the ability to correct billing errors, submit clean claims electronically or on paper, and document relevant activities in account notes to present clear and concise reports to management. The specialist will review payment variances and remittances for resolution and respond promptly to inquiries regarding high dollar or complex accounts. Maintaining compliance with HIPAA, OSHA, and company regulations is paramount, and the specialist will be expected to identify payer issues or trends and communicate these to management effectively. Other duties may be assigned as necessary, and the position requires a high school diploma, with certification in medical coding being a plus. Previous experience in a medical group practice environment and familiarity with medical accounts receivable, claims appeal, and coding are preferred.

Responsibilities

• Perform consistent, assertive, efficient and timely follow-up on accounts as determined by Management.
• Assist in the increase of cash collection and the decrease of Accounts Receivables (AR) aging for designated plan(s).
• Understand and effectively interpret payer contracts, Remittance Advices (RA) and Explanation of Benefits (EOB) statements.
• Engage with Medicare, Medicaid, and/or Third Party Payer experience in dealing with healthcare insurance companies through phone follow-up and letter correspondence during the appeals or denial resolution process.
• Correct billing errors, edits, overlaps, etc., and submit clean claims electronically or on paper.
• Demonstrate knowledge of insurance and billing forms and investigate and resolve debit and credit account balances.
• Document relevant activity in account notes clearly and succinctly for management reporting.
• Review payment variances and remittances for resolution in an efficient and timely manner.
• Respond in a timely manner to inquiries regarding high dollar or complex accounts.
• Identify payer issues or trends and update Manager in a timely manner.

Requirements

• High School Diploma or GED.
• Previous experience in a medical group practice environment preferred.
• Experience in medical accounts receivable, claims appeal, and coding preferred.
• Certification in Medical Coding is a plus.
• Certified Patient Service Specialist (CPSS) must be obtained within 6 months of hire date.

Nice-to-haves

• Certification in Medical Coding
• Certified Patient Service Specialist (CPSS)

Benefits

• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance