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Job Details Job Location Henderson - 1711 Whitney Mesa - Henderson, NV Position Type Full Time Education Level High School Salary Range $20.00 - $21.00 Hourly Job Shift Day Job Category Admin - Clerical Description

Position Summary:

The AR Specialist will oversee the billing receivables and functions under the direction of the Billing Supervisor. The ideal candidate will have excellent organizational, and Microsoft excel skills, ability to multi-task and meet various deadlines while managing all open accounts receivable from the medical billing department. Understanding and implementing applicable billing requirements that can differ across insurance companies on a contract-by contract basis is necessary. Ability to quickly adapt to changes and maintain positive and professional relationships with payers will be required. Clear and effective communication at prominent levels.

Essential Job Functions:

  • Assists the Billing Supervisor with billing and EOB review. Understanding medical coding, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management.
  • Manage daily payment from various payers by quickly and accurately posting from the EOP to the billing tracking logs.
  • Review the documented reasons for denials that cannot be re-billed and communicate this to the Supervisor. Maintain tracking trends report for Supervisor review.
  • Produce Monthly reconciliation report of all payments and open claims with detail on status and estimated dates for complete payment acceptance.
  • Ability to quickly analyze claims submission and processing reports for issues that could cause errors and/or delays in payment.
  • Work with Billing Supervisor and VP of Revenue Cycle Management to communicate issues with service collection including but not limited to lack of insurance authorization, inconsistent insurance verification, issues with claims processing and credentialing barriers.
  • Ability to build and maintain numerous Microsoft excel based tracking systems including formats, formulas and tab linking.
  • Manage appeals and reconsiderations for all four managed care contracts and Medicaid fee for service to attempt to reach a collection ratio of 95%
  • Assist with insurance audits as needed.
  • Ability to understand Utilization Management and Review including verification of proper authorizations needed for various levels of care.
  • Process insurance verification for Medicaid and private insurances as needed.
  • Ability to communicate effectively in writing, over the telephone, and in person.
  • Ability to work under minimum supervision.
  • Perform other duties as assigned.
Qualifications

Essential Qualifications:

Certifications/Licenses:

  • Billing/Coding certification a plus

Education:

  • Graduation from an accredited two-year college with a degree in Health Administration, Business Administration or related field is preferred.
  • High School Diploma or equivalent and at least two years in billing / accounting - related fields

Work experience may be substituted for a degree.

Experience and Competencies:

  • 2+ years of billing experience (medical/insurance billing preferred)
  • Knowledge of Medical Terminology, CPT, ICD-10 and HCPCS Codes.
  • Able to delegate and multi-task.
  • Advanced computer skills.
  • Excellent documentation and organizational skills.
  • Must have the ability to pass a criminal history background screening, obtain CPR & First Aid Certification and an Annual Tuberculosis Test.

Working Conditions:

  • Work is performed in a well-lit office setting.

Essential Physical and Mental Demands of the Job

The employee must be able to perform the following essential duties and activities with or

without accommodation:

Physical Demands:

  • Must be able to sit majority of the day with occasional walking and/or standing.
  • Ability to lift and move up to 15 pounds as needed.

I acknowledge receipt of this position description, and understand I am responsible for understanding its contents, and to ask for clarification if I have any questions. I further understand this description is intended to describe the essential job functions and qualifications for this position. It is not an exhaustive list of all duties, responsibilities and requirements of a person so classified. Other functions may be assigned and management retains the right to add or change the duties at any time.

_____________________________________________ ____________

Employee Signature Date