Medical A/R Appeals and Denials Specialist

Medical A/R Appeals and Denials Specialist We are seeking a motivated Medical Billing A/R Specialist to join our team and follow-up on outstanding A/R including unpaid/underpaid/denied claims. The successful candidate will play a crucial role in resolving outstanding claims resulting in maximum reimbursement. We are an established Psychiatry practice centrally located in Las Vegas. This position is not remote.

• Responsibilities:

• Timely follow-up and resolution on all outstanding A/R including unpaid/underpaid/denied claims for all payers including self-pay to obtain maximum reimbursement.

Prioritize high dollar claim balances through work queues Review & work incoming insurance and patient correspondence including refund requests. Send appeals when appropriate or provide the requested medical documentation. Ability to review medical documentation to justify medical necessity. Review patient balances to ensure accuracy and follow up with patients to obtain payments. Take incoming patient phone calls to resolve inquiries, billing issues, or outstanding balances. Review insurance payments and determine accuracy of reimbursement based on contracts, fee schedules or summary plan documents. Leverage knowledge of Medicare, state Medicaid, and local coverage determinations (LCD's) for claim resolution. Recommend an adjustment when applicable or recommend a refund for overpayments to insurance carriers or patients, providing the appropriate documentation.

• Qualifications:

• Minimum 1 year of experience in medical billing in a verifiable A/R role AdvancedMD EHR experience required Familiar with all Nevada insurances Proficient in medical EHR software and familiar with CPT and ICD-10 coding Ability to read and comprehend Explanation of Benefits (EOBs) Proficient with Microsoft Office, Windows and the ability to operate basic office equipment Excellent communication and interpersonal skills Able to work independently with minimal supervision and also work as a team when needed Strong analytical and problem-solving skills Exceptional attention to detail and accuracy Behavioral health preferred but not required Insurance eligibility experience preferred Medisoft EHR experience a bonus •

Benefits:

• Competitive pay based on experience Benefits package including Medical/Dental/Vision Life insurance package offered.

Hospitalization package covered by employer 100% Opportunity to work in a fast-paced and rewarding environment Paid time off and sick leave Retirement contribution program

Job Type:

Full-time Pay:

$18.00 - $23.00 per hour

Benefits:

Dental insurance Health insurance Paid time off Vision insurance

Work Location:

In person