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
• Appropriately 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 North Carolina.