AR​/Denials Specialist

Overview

Summit Spine and Joint Centers is a rapidly expanding Pain Management Group looking to add an experienced Accounts Receivable / Denials Specialist to our team. With fifteen ambulatory surgery centers and thirty-one clinic locations across Georgia, Summit Spine is winning the race to become the largest comprehensive spine and joint care provider in the state of Georgia. We are looking for a motivated and hard-working AR / Denials Specialist who can join our growing team of professionals.

• Processes assigned AR, working to 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
• Manages outstanding accounts to include following up with insurance carriers for over payments, underpayments, filing corrected claims, appealing claims, and following up on all denials to ensure processing / reprocessing and timely payments
• Review AR aging to ensure timely collection of payments
• Review and initiate payor and patient refunds
• Adequately documents issues, sources, and actions taken on each account
• Identify, document, and report payer denial trends to billing manager for escalated follow-up
• Creates 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
• Follows 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 of office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management
• Knowledge of medical billing rules, such as coordination of benefits, modifiers, and understanding of EOBs and ANSI code denials.
• Excellent knowledge of CPT coding, ICD.
  10 coding and medical pre-certification protocols required
• 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 401k 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.