AR Specialist (Full-Time)
About Diana Health
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