Insurance AR Specialist - Advanced Orthopaedics & Sports Medicine
Summary
Processes insurance claims, tracks accounts receivable, and resolves billing discrepancies for a medical billing team in a healthcare setting.
The Medical Billing and Insurance AR Specialist reports to the Billing Manager and is responsible for insurance claim clarification, accounts receivable follow-up, and payment posting. The role serves as a liaison between the billing department and providers, handling billing inquiries and claim corrections. The specialist ensures accurate coding compliance for all procedures and contributes to reducing AR through diligent follow-up on outstanding claims. Other duties include processing refunds, handling patient insurance information updates, and assisting in the development of training programs for the billing team.
Key Responsibilities:
- Basic understanding of insurance payer policies and guidelines for follow up on insurance claims and accounts receivable to ensure timely payment.
- Liaise with billing department and providers to resolve billing issues.
- Claim creation and filing via data entry, provided from 3rd party vendors
- Monthly reports for unpaid claims for ancillary services
- Ensure accurate coding and compliance with regulations on aged (120+ days) unpaid claims
- Resolve discrepancies in insurance payments and posting errors.
- Process refund requests and update patient insurance information.
- Document insurance and patient correspondence and assist with billing team training.
- Basic payment posting and reconciliation from insurance and/or patients.
- Understanding of explanation of benefits for accurate assistance with patient billing questions.
- Experience and understanding of excel functions is a must