AR​/Denials Specialist

Summit Spine and Joint Centers is a rapidly expanding pain management group with fifteen ambulatory surgery centers and thirty-one clinic locations across Georgia. We are looking for an experienced Accounts Receivable / Denials Specialist to join our growing team of professionals.

• Process assigned AR and maximize collections while minimizing aging AR.
• Process insurance denials and appeals to ensure timely account resolution.
• Identify denial trends and provide management with a summary of identified issues.
• Manage outstanding accounts, including following up with insurance carriers for over payments, underpayments, filing corrected claims, appealing claims, and ensuring processing/reprocessing and timely payments.
• Review AR aging to ensure timely collection of payments.
• Review and initiate payor and patient refunds.
• Appropriately document issues, sources, and actions taken on each account.
• Identify, document, and report payer denial trends to the billing manager for escalated follow‑up.
• Create reports regarding the status of patient accounts as requested.
• Address inquiries from insurance companies, patients, and providers.
• Ensure claim information is complete and accurate.
• Post office paper zero pay denials and scan into our system.
• Verify patient benefits and eligibility.
• Maintain denials productivity spreadsheet.
• Follow HIPAA guidelines in handling patient information.

• Minimum of 3 years’ experience with accounts receivable or revenue cycle in a medical setting.
• Experience with Medicare, Medicaid, commercial insurance plans, workers’ comp, and personal injury cases.
• Knowledge of claims submission for office visits, outpatient procedures, urinary drug screens, DME, MRI, and chronic care management.
• Knowledge of medical billing rules, such as coordination of benefits, modifiers, EOBs, and ANSI code denials.
• Excellent knowledge of CPT coding, ICD‑10 coding, and medical pre‑certification protocols.
• Excellent computer skills and familiarity with Microsoft Office.
• Comfortable working in a growing, dynamic organization and able to navigate change.
• Self‑motivated with ability to multi‑task, prioritize work in a fast‑paced, team environment.
• Bachelor’s degree preferred.
• Experience using eClinical
  
  Works preferred.
• Experience with pain management preferred.

The position is full time with competitive salary, PTO, health benefits, and a 401(k) match. The ideal candidate will be located in Georgia and able to be present at our administrative office, or near Austin, Texas where a subset of the billing team are located.

Mid‑Senior level

Full‑time