AR​/Denials Specialist

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Summit Spine and Joint Centers is a rapidly expanding Pain Management Group looking to add an experienced Accounts Receivable / Denials Specialist to our team. With fifteen ambulatory surgery centers and thirty-one clinic locations across Georgia, Summit Spine is winning the race to become the largest comprehensive spine and joint care provider in the state of Georgia. We are looking for a motivated and hard‑working AR / Denials Specialist who can join our growing team of professionals.

• Process assigned AR to maximize collections while minimizing aging AR.
• Process insurance denials and appeals to ensure timely account resolution.
• Identify denial trends and provide management with a summary of identified issues.
• Manage outstanding accounts, including following up with insurance carriers for over payments, underpayments, filing corrected claims, appealing claims, and ensuring all denials are processed/reprocessed and paid on time.
• Review AR aging to ensure timely collection of payments.
• Initiate payor and patient refunds.
• Document issues, sources, and actions taken on each account.
• Report payer denial trends to billing manager for escalated follow‑up.
• Create reports regarding the status of patient accounts as requested.
• Address inquiries from insurance companies, patients, and providers.
• Ensure claim information is complete and accurate.
• Post office paper zero pay denials and scan into our system.
• Verify patient benefits and eligibility.
• Maintain denials productivity spreadsheet.
• Follow HIPAA guidelines in handling patient information.

• Minimum of 3 years’ experience with accounts receivable or revenue cycle in a medical setting.
• Experience with Medicare, Medicaid, commercial insurance plans, workers’ comp, and personal injury cases.
• Knowledge of claims submission for office visits, outpatient procedures, urinary drug screens, DME, MRI, and chronic care management.
• Knowledge of medical billing rules such as coordination of benefits, modifiers, and understanding of EOBs and ANSI code denials.
• Excellent knowledge of CPT coding, ICD‑10 coding, and medical pre‑certification protocols.
• Excellent computer skills and familiarity with Microsoft Office.
• Comfortable working in a growing, dynamic organization and able to navigate change.
• Self‑motivated, able to multi‑task, prioritize work in a fast‑paced, team environment.
• Bachelor’s degree preferred.
• Experience using eClinical
  
  Works preferred.
• Experience with pain management preferred.

The position is full time with competitive salary, PTO, health benefits, and 401(k) match. The ideal candidate will be located in North Carolina.

Mid‑Senior level

Full‑time

Accounting/Auditing and Finance

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