What are the responsibilities and job description for the PI Billing AR Specialist I position at SimonMed?
Join the fastest growing outpatient radiology practice in the Nation - SimonMed Imaging! Our commitment to excellence and improving patient care paired with the best-in-class technology allows us to be an industry leader in the constantly evolving health care environment. Secure your spot now and take advantage of a unique career opportunity to advance your skills while working alongside a dedicated team of board-certified subspecialty radiologists. We can’t wait to meet you!
LOCATION: Remote
As a PI Billing AR Specialist 1, you will work closely with AR Specialist II, Team Lead, and Supervisor to evaluate and rectify billing issues.
ESSENTIAL FUNCTIONS:
- Research systems to provide updated demographic information
- Patient following up as needed to assist with payment options
- Review accounts in the billing system to verify claim handling was appropriate
- Update claims and reprocess as necessary
- Review and update posted adjustments as necessary
- Review EOB for accuracy of payment posting
- Locate and post checks that have not been posted to the system
- Ability to delegate work to other team members and departments as necessary
- Follow up with auto insurance adjusters for bill status
- Research patient inquiries and provide information to the manager regarding the handling of the patient’s account and launch case investigations with billing service to instruct on proper account handling (i.e. appeals to be filed with insurance, claims handled incorrectly, etc.).
- Launch case investigations with billing service to instruct on proper account handling (i.e. appeals to be filed with insurance, claims handled incorrectly, etc.)
- Report any trending errors/issues to the Supervisor
- Follow up with insurances and/or attorneys on claims balances
- Assist with escalations from Customer Service Representative, PI Billing Representative I &II when necessary
- Use coded data to produce and submit claims to insurance companies using CMS 1500 forms
- Work directly with the insurance company, representing attorney and patient to get a claim processed and paid, such as verifying the date of the accident, claims address, and adjuster information
- May be responsible for, or assist in new employee training
*Minimum 120 accounts worked per day
- Demonstrates competency in the performance of job-related skills appropriate to his/her customer populations and departmental services while providing excellent customer service.
- Utilizes and operates equipment and mechanical devices which provide for a functional, effective, and safe environment.
- Adheres to policies, procedures, guidelines relative to departmental operations.
OTHER DUTIES: Please note this job description is not designed to cover or contain a comprehensive listing of all activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time or without notice.
BENEFITS: Your health, happiness and future matters! At SimonMed Imaging, we offer medical, vision and dental insurance, 401(k) eligibility, paid holidays plus PTO, Sick Time, opportunity for growth, and much more!
MINIMUM QUALIFICATIONS:
- Must have a High School diploma with 3 or more years of experience in full RCM.
- Must have knowledge of HIPAA guidelines, experience with Microsoft Word and Excel. Intermediate to Advanced knowledge of Medical Billing.
- Must be able to communicate effectively with attorneys, other SMI employees, patients, and the public and establish good working relationships with internal and external customers.
PHYSICAL DEMANDS: This position may require duties including lifting and carrying up to 40 pounds, sitting for prolonged periods of time, with frequent standing and walking.
DRESS ATTIRE: Business Casual or scrubs dependent on department
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Employment is contingent upon successful completion of drug and background screening. Some positions will require a favorable driving record.
