AR Follow Up Specialist

Duties and Responsibilities

Primary Job Functions:

• Monitors unresolved account balances according to the Aged Receivables and assigned tasks
• Validates third-party payer transactions and identifies reasons for delay of payment through the review of EOBs via paper, payer portals, and/or phone calls, determines next steps, and documents actions taken in the billing system
• Maintains knowledge of third-party filing requirements and ensures claims are not rejected due to timely filing
• Resolves third-party claim rejections and/or denials in a timely manner
• Prepares appeals via appropriate means according to carrier guidelines for all claims that require reconsideration for appropriate or additional payment
• Makes necessary claim adjustments and rebills third party payers as needed
• File claims to secondary payers with primary EOB’s/COB information
• Collaborates with the billers and other internal departments to satisfy the requirements for resolving unpaid insurance balances
• Posts adjustments, transfer of responsibility, and/or initiates refunds, as necessary.
• Ensures coding is compliant and up to date
• Performs all routine follow-up functions which includes the investigation of overpayments, underpayments, credit balances and payment delays.
• Ensures payments are made according to third-party contracts
• Reports payer specific issues to Revenue Cycle Supervisor in a timely manner
• Conveys observations of trends to the Revenue Cycle Supervisor to encourage best practices and mitigate repeat issues
• Makes recommendations to the Revenue Cycle Supervisor regarding non-collectable accounts
• Other duties as assigned.

Secondary Job Functions:

• Opening, sorting, delivering and scanning incoming correspondence
• Processes all Returned Mail including skip tracing and contacting various resources for information
• Assists with data entry
• Attend meetings and training sessions
• Maintain confidentiality of patient and financial information by utilizing HIPAA guidelines and regulations
• Maintain knowledge and adhere to related governmental regulations and all policies set forth by Ohio Gastroenterology Group Inc and its related parties

Knowledge, Skills and Abilities

• Knowledge of third-party payers and prior-authorization requirements
• Understanding of basic medical terminology and procedures
• Proficient use of office equipment, such as copier and fax machine, phones, etc.
• Intermediate computer skills including use of Microsoft Office (Excel and Word), electronic mail, payer websites, physician practice management, and electronic medical records systems.
• High attention to detail and the ability to multi-task.
• Strong time management skills
• Ability to work independently with minimal supervision and to manage multiple priorities.
• Strong written and verbal communication skills
• Ability to effectively communicate with a variety of people under stressful circumstances.
• Neat appearance, professional demeanor and pleasant voice
• Fluent in English

Credentials and Experience

• Must have high school diploma or equivalent
• One (1) year of medical billing and coding, revenue cycle, and/or AR follow-up experience
• Experience with eClinicalWorks a plus
• Experience in GI a plus

Physical Demands

• Must be able to bend over (frequent), climb stairs (frequent), sit (frequent), stand (frequent), stoop (frequent), walk (frequent) and type on keyboard (frequent).

Work Environment

• Minimal medical office exposure that may require contact with adult patients
• Office workstation environment with numerous employees

Ohio Gastroenterology Group offers a nice life/work balance and a great benefits package that includes:

• Medical, dental and vision coverage- benefits are effective the first of the month following 30 days of employment
• Company paid life insurance and short term disability
• Generous paid time off plans (vacation, sick and personal)
• 7 paid holidays
• Two retirements plans:
• 401(k) plan that offers a 3% safe harbor contribution with immediate vesting as well as annual profit sharing contributions.
• Cash balance pension plan – company contributes 2.5% and offers full vesting after 3 years of employment.
• Tuition reimbursement programs
• Employee appreciation programs
• Uniform reimbursement programs
• Growth opportunities
• Learning and development training

Apply now to join a great company!