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Diana Health · 2 days ago

AR Specialist (Full-Time)

United States

Full-time

Remote

Mid Level

3+ years exp

Diana Health is a high-growth network of modern women's health practices on a mission to inspire and support women to live healthier lives. The AR Specialist will manage physician billing functions, resolve insurance denials, and advocate for patients throughout the billing process.

Health CarePersonal HealthWellnessWomen's

Responsibilities

Utilize expertise in OB/GYN billing processes to investigate and resolve insurance denials through effective communication with payers and attention to detail in claim resubmissions

Navigate various payer portals to monitor claim status and eligibility and resolve issues promptly

Collaborate with internal teams to gather and provide necessary appeals and claims processing documentation

Maintain up-to-date knowledge of medical billing regulations and compliance requirements

Utilize medical collection practices and procedures to manage outstanding accounts receivable

Ensure accuracy in data entry and record-keeping for billing-related activities

Prioritize tasks effectively to meet deadlines and achieve goals

Complies with Revenue Cycle policies and procedures

Works assigned task lists, work queues, work files and reports

Maintains current knowledge of third-party payor reimbursements and managed care contracts

Maintains knowledge and is familiar with physician billing, accounts receivable, and EHR systems

Utilizes and identifies all components of Explanation of Benefits (EOB)/Explanation of Payments (EOP)

Accurately counts and tracks all daily activities and production

Completes and accurately documents activity or communication on accounts

Meets department production standards consistently as defined by department management

Works special projects as assigned by Manager, Supervisor, or others

Skill and ability to communicate effectively both verbally and in-writing

Ability to read and comprehend simple instructions, short correspondences, and memos

Ability to write simple correspondence

Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization

Adds, subtracts, multiplies, and divides in all units of measure, using whole numbers, common fractions, and decimals

Ability to understand and calculate figures and amounts such as simple discounts, interests, and percentage measures and to read tabular and bar graphs

Skill and ability in Physician Billing Systems (PB), Electronic Medical Records (EMR), and Microsoft Office applications with working usage of MS Word, Outlook, and Excel

Extensive knowledge on use of email, search engines, Internet, and ability to effectively use payor websites and portals

Requires proficiency with various healthcare computer system applications that are used by physicians in the office and in hospital settings to support patient care, billing, and financial information

Ability to advocate on patient’s behalf, listen to patient concerns attentively, and address patient matters promptly, courteously, and respectfully

Qualification

OB/GYN billingMedical billing processesAccounts receivable managementMedical terminologyPhysician Billing SystemsElectronic Medical RecordsCustomer serviceCommunication skillsOrganizational skillsAttention to detail

Required

High school diploma or GED required

3 to 5 years of experience in medical claims collection and be familiar with aging reports, delinquent claims reports, correspondence, EOBs, and other sources of information

Demonstrated ability to be detail oriented with strong aptitude for accuracy required

Demonstrated ability to effectively work with others required

Knowledge of proper business writing standards for letters and memos including the ability to write a correspondence with proper punctuation, grammar, spelling, etc

Proven effective verbal, listening and written communications skills