Billing & A​/R Specialist

OnPoint Medical Group is searching for an outstanding Billing & A/R Specialist to join our team! Come join a great group of medical professionals as our network continues to grow! OnPoint Medical Group is a physician-led network of skilled Primary and Urgent care providers who are committed to expanding access to quality healthcare in the most effective and affordable manner possible.

Our "Circle of Care" has one primary goal – to ensure the health and wellness of members and their families. We do this by providing access to a comprehensive menu of medical services from one unified physician group in their neighborhoods. With doctors, nurses, specialists, labs and medical records all interlinked and coordinated, patient care has never been in better hands.

Billing and A/R specialist requirements include full revenue cycle duties, including submitting a clean claim and/or assisting with said submission, verifying that contractual payment is received and/or appealing a denial, answering patient phone calls and reviewing patient statements, working A/R.

The Billing & A/R Specialist is responsible for supporting all aspects of the revenue cycle, including claims submission, payment review, denial follow-up, appeals, patient account support, and accounts receivable management. This role requires strong attention to detail, knowledge of medical billing processes, and the ability to communicate effectively with patients, providers, and insurance carriers.

The following statements describe the essential functions of this role. They are not intended to be an exhaustive list of all duties, responsibilities, or qualifications required. OnPoint Medical Group reserves the right to modify job responsibilities at any time.

• Work directly with insurance companies, healthcare providers, and patients to ensure claims are processed accurately and paid in a timely manner.
• Submit clean claims or assist with claim submission as needed.
• Verify contractual payments and investigate payment discrepancies.
• Review, correct, and appeal unpaid or denied claims.
• Run and analyze A/R reports.
• Work unpostables, denials, and claim worklists in accordance with Athenahealth best practices.
• Respond to patient calls regarding billing questions and account statements.
• Review and resolve outstanding accounts receivable balances.

Resolve a minimum of 37 claims per day from assigned claim worklists.

Note:

Goal may vary based on payor type, projects, other assignments, etc.

Maintain accounts receivable balances at less than 180 days outstanding.

Perform duties in accordance with the standard Billing Compliance and Billing Guidelines. Maintain and follow strict privacy, confidentiality, and safety standards. Comply with all applicable governmental and regulatory requirements, including:

• HIPAA
• OSHA
• PCI DSS

Maintain a clean, organized, and professional work environment. Distribute faxes and related documents to billing department staff, as appropriate. Perform other administrative duties as assigned.

To perform this job successfully, an individual must be able to carry out each essential duty satisfactorily. The qualifications listed below are representative of the knowledge, skills, and abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• High school diploma or equivalent
• Strong computer skills
• Minimum of 5 years of healthcare experience
• Minimum of 1 year of medical billing experience

• Some college coursework in medical administration, business, or…