AR Specialist (Full-Time) Full Time NEW

Diana Health is a high-growth network of modern women’s health practices. We are on a mission to set a new standard of care that inspires, empowers, and supports women to live healthier, more fulfilling lives. We partner directly with hospitals and align incentives across stakeholders using integrated care teams, smart technology, and a designed care experience that is good for patients and good for providers. The result is an individualized, comprehensive care program that puts women in the driver’s seat of their own health and provides them with the information and compassionate care they need to reach their health goals.

We are an interdisciplinary team joined together by our shared commitment to transform women’s health. Come join us!

Description

The AR Specialist is a multi-tasking highly skilled position that encompasses all key functions of physician billing. The AR Specialist position requires an advanced revenue cycle knowledge that has been acquired through experience and developed through training and education. The AR Specialist supports patient-centered care and Customer Service by serving as a patient advocate during the life cycle of the account. Under direct supervision, the AR Specialist is expected to maintain productivity, accountability, and produce very efficient and proficient results.

The AR Specialist is a highly motivated individual with a proven ability to manage multiple tasks. The AR Specialist will possess extensive knowledge of medical billing processes focusing on OB/GYN billing and insurance denials and be proficient in medical terminology, coding, and billing systems. The AR Specialist will manage telephone calls from patients, insurance companies, and medical practices to answer inquiries, follow up on outstanding claims, and update accounts as required. The AR Specialist will possess exceptional organizational skills, a mature, pleasant, and professional telephone manner, and the ability to prioritize work. The AR Specialist ensures that the aging Accounts Receivable (AR) is kept current and that all denials are researched and updated. The AR Specialist will respond effectively to sensitive inquiries or patient complaints to Diana Health’s patient population.

What You’ll Do

• Utilize expertise in OB/GYN billing processes to investigate and resolve insurance denials through effective communication with payers and attention to detail in claim resubmissions
• Navigate various payer portals to monitor claim status and eligibility and resolve issues promptly
• Collaborate with internal teams to gather and provide necessary appeals and claims processing documentation
• Maintain up-to-date knowledge of medical billing regulations and compliance requirements
• Utilize medical collection practices and procedures to manage outstanding accounts receivable
• Ensure accuracy in data entry and record-keeping for billing-related activities
• Prioritize tasks effectively to meet deadlines and achieve goals

Core Revenue Cycle Functions

• Complies with Revenue Cycle policies and procedures
• Works assigned task lists, work queues, work files and reports
• Maintains current knowledge of third-party payor reimbursements and managed care contracts
• Maintains knowledge and is familiar with physician billing, accounts receivable, and EHR systems
• Utilizes and identifies all components of Explanation of Benefits (EOB)/Explanation of Payments (EOP)
• Accurately counts and tracks all daily activities and production
• Completes and accurately documents activity or communication on accounts
• Meets department production standards consistently as defined by department management
• Works special projects as assigned by Manager, Supervisor, or others

Knowledge, Skills, Abilities

Language/Communication Skills

• Skill and ability to communicate effectively both verbally and in-writing
• Ability to read and comprehend simple instructions, short correspondences, and memos
• Ability to write simple correspondence
• Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization

Mathematical Skills

• Adds, subtracts, multiplies, and divides in all units of measure, using whole numbers, common fractions, and decimals
• Ability to understand and calculate figures and amounts such as simple discounts, interests, and percentage measures and to read tabular and bar graphs

Computer / Technical Skills

• Skill and ability in Physician Billing Systems (PB), Electronic Medical Records (EMR), and Microsoft Office applications with working usage of MS Word, Outlook, and Excel
• Extensive knowledge on use of email, search engines, Internet, and ability to effectively use payor websites and portals
• Requires proficiency with various healthcare computer system applications that are used by physicians in the office and in hospital settings to support patient care, billing, and financial information.

Customer Service Skills

• Ability to advocate on patient’s behalf, listen to patient concerns attentively, and address patient matters promptly, courteously, and respectfully.

Qualifications

• High school diploma or GED required
• 3 to 5 years of experience in medical claims collection and be familiar with aging reports, delinquent claims reports, correspondence, EOBs, and other sources of information.
• Demonstrated ability to be detail oriented with strong aptitude for accuracy required
• Demonstrated ability to effectively work with others required
• Knowledge of proper business writing standards for letters and memos including the ability to write a correspondence with proper punctuation, grammar, spelling, etc
• Proven effective verbal, listening and written communications skills

Benefits

• Competitive compensation
• Health; dental & vision, with an HSA/FSA option
• 401(k) with employer match
• Paid time off
• Paid parental leave

Diana Health Culture

• Having a growth mindset and striving for continuous learning and improvement
• Positive, can do / how can I help attitude
• Empathy for our team and our clients
• Taking ownership and driving to results
• Being scrappy and resourceful