OB/Gyn AR Specialist

Job Summary:

The intent of this job description is to provide a summary of the major duties and responsibilities performed in this job. Incumbents may be requested to perform job-related tasks other than those specifically presented in this description.

The OB/Gyn Accounts Receivable Specialist & Patient Financial Advisor is responsible for ensuring accurate, timely filing of medical claims and bills to various payers and patients. This process includes review of medical encounter notes, application of appropriate procedure codes, diagnoses, and modifiers. The candidate will be responsible for the full revenue cycle including billing, payment posting, follow-up and financial reconciliation. Candidate will work to achieve Revenue cycle timelines and goals. Candidate can communicate effectively to providers and clinical staff on medical documentation guidelines. There may be other job duties as assigned.

Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Reviewing medical documentation and billing for errors, to ensure a clean claim is submitted the first time.
• Fielding patient and staff billing questions.
• Follow up on unpaid and denied claims.
• Insurance and patient payment posting and reconciliation.
• Work cooperatively with others, including appropriate communication with patients, providers, support staff and administration.
• Comply with all company policies and procedures found in the employee handbook.

Required education and experience: The requirements listed below are representative of the knowledge, skills, and/or ability required.

Minimum Education required:

• High school graduate or equivalent.
• Medical billing or coding certification preferred.

Minimum Experience Required:

• Required 5 years of revenue cycle experience.
• Knowledge of Epic EMR software is a plus.

Minimum Knowledge and Skills Required:

• Understanding and proficient use of medical billing guidelines and regulations. Knowledge of regulations as set forth by CMS, OIG, commercial insurances, and other regulatory agencies.
• Knowledge of CPT, ICD-10, and HCPCS codes, as well as appropriate modifier usage for billing and following up on open AR claims.
• Familiar with billing all major medical insurances, including Medicare, Tricare, and commercial payers.
• Ability to communicate effectively and congenially with patients and staff members in person and over the phone.
• Ability to exercise tact, initiative, and good judgement when interacting with patients and staff members.
• Work experience in Office 365 business tools such as Outlook, Excel, Word etc.
• Ability to navigate and accurately input within the Practice Management System
• Ability to navigate in the EMR and other source systems.
• Ability to accept supervision and feedback.
• Ability to look for patterns of events, provides feedback and solutions.
• Critical thinking and analytical skills to review accounts and medical documentation.

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