AR Specialist

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    "region": "TX",
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    "datePosted": "2024-06-06T08:27:32.380Z",
    "description": "<h2>Company Overview</h2>\n<p>Join Houston Retina Associates </p>\n<p> </p>\n<p>At Houston Retina Associates, we’re more than a leading ophthalmology practice—we’re a team dedicated to preserving and restoring vision for our patients. Specializing in advanced care for retinal conditions like macular degeneration, diabetic retinopathy, and retinal detachment, we combine cutting-edge technology with compassionate, personalized treatment. Our culture is built on collaboration, innovation, and continuous learning. We value every team member’s contribution and provide opportunities for professional growth in a supportive environment. With multiple locations across the greater Houston area, we’re proud to serve our community and make a meaningful impact every day. If you’re passionate about excellence in patient care and want to be part of a team that truly makes a difference, we invite you to join our team! </p>\n<p> </p>\n<p>Houston Retina Associates is affiliated with EyeSouth Partners' premier network of medical and surgical specialty eye care services.</p>\n<p> </p>\n<h2>Position Summary</h2>\n<p>The A/R Specialist is responsible for the company’s third-party medical claims processing and assisting patients and office staff with questions on insurance claims, authorizations, statements, and other billing issues. This position will prepare, submit and follow-up on medical claims for Managed Care Organization (MCO), Medicaid, Medicare, Other Federal, Private Insurance, and Workers Compensation.</p>\n<p> </p>\n<p><strong>This is a Hybrid Position, the A/R Specialist will be expected to work in person at our Houston Office one day a week.</strong></p>\n<p> </p>\n<p><strong>**Applicants who live and plan to work from the following states will not be considered at this time: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Idaho, Montana, Maryland, Massachusetts, Michigan, Nevada, New Mexico, Oregon, New Hampshire, New Jersey, Utah, New York, Rhode Island, Washington, and Wyoming. Thank you for your interest.</strong></p>\n<h2>Responsibilities</h2>\n<ul>\n <li>Files and processes primary and secondary third-party medical </li>\n <li>Verifies all the information for claims processing is complete and </li>\n <li>Contacts the appropriate person to obtain missing or unclear billing </li>\n <li>Follows-up by website and/or telephone on all unpaid and denied claims to determine next course of action, which may require rebilling missing claims, denied claims or sending additional information on pending claims</li>\n <li>Sends appeal letters to insurance </li>\n <li>Obtains authorizations when needed.</li>\n <li>Identifies and corrects charge entry/ billing </li>\n <li>Provides proper documentation to insurance companies.</li>\n <li>Handles insurance company questions, complaints, and/or responds to and interacts with patients concerning all aspects of billing through phone, e-mail, or regular mail in a prompt and courteous </li>\n <li>Documents all actions and maintains permanent records of patient </li>\n <li>Assists with answering phones, screening calls and following-up on</li>\n <li>Works with management on patient billing and insurance </li>\n <li>Processes refunds to patients and insurance </li>\n <li>Works with outside programs (i.e., co-pay assistance) to ensure proper </li>\n <li>Communicates with front office staff to attempt to collect any outstanding patient </li>\n <li>Contributes to the team effort by completing other tasks and projects as needed</li>\n</ul>\n<h2>Qualifications</h2>\n<ul>\n <li>Minimum of two (2) years Medical Insurance/Healthcare Billing and Collections experience in a medical practice or health system</li>\n <li>CPC, CPOC, COC certifications a plus</li>\n <li>Six months of previous customer service experience preferred</li>\n <li>Prior experience with an electronic medical record system required (EHR/EMR)</li>\n <li>Working knowledge of medical billing, collections and payment posting, revenue cycle, third party payers, Medicare; and strong knowledge of Federal payer regulations</li>\n <li>Working knowledge of CPT and ICD10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits and appeal processes</li>\n <li>Ability to handle sensitive and confidential information in a professional manner</li>\n <li>Maintains knowledge of coordination of benefits requirements and processes</li>\n <li>Demonstrated success working in a team environment focused on meeting organization goals and objectives is necessary</li>\n <li>Self-motivated with strong organizational skills and superior attention to detail</li>\n <li>Ability to review documents for accuracy and reasonability</li>\n <li>Ability to work well under pressure</li>\n <li>Ability to multi-task, set priorities and follow through without direct supervision</li>\n <li>Effectively communicate with physicians, patients, insurers, colleagues, and staff</li>\n <li>Intermediate computer skills including Microsoft Office; especially Word, Excel, and PowerPoint</li>\n <li>Knowledge of policies and procedures to accurately answer questions from internal and external customers</li>\n <li>Detail oriented and tolerant of frequent interruptions and distractions from patients and staff</li>\n <li>Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external</li>\n <li>Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level</li>\n <li>Team player that develops strong collaborative working relationships with internal partners and can effectively engage and ability to build consensus among cross-functional teams</li>\n</ul>\n<h2>Company Benefits</h2>\n<p>We offer a competitive benefits package to our employees:</p>\n<ul>\n <li>Medical</li>\n <li>Dental</li>\n <li>Vision</li>\n <li>401k w/ Match</li>\n <li>HSA/FSA</li>\n <li>Telemedicine</li>\n <li>Generous PTO Package</li>\n</ul>\n<p>We also offer the following benefits for FREE:</p>\n<ul>\n <li>Employee Discounts and Perks</li>\n <li>Employee Assistance Program</li>\n <li>Group Life/AD&D </li>\n <li>Short Term Disability Insurance </li>\n <li>Long Term Disability Insurance </li>\n</ul>\n<p>EyeSouth Partners is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.</p>\n<p> </p>",
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