AR Calling Specialist for Hospital Billing Operations
2 weeks ago
**Job Summary**
We are seeking a detail-oriented and experienced AR Calling Specialist with a minimum of 5 years of industrial experience in hospital billing and claims management. The ideal candidate will be responsible for managing denied claims, resolving billing issues, and optimizing revenue recovery.
**Key Responsibilities:**
- Claim Review: Analyze and review denied claims, identify denial trends, and determine reasons for denials.
- Appeal Preparation: Prepare and submit appeals for denied claims, ensuring the inclusion of all required documentation.
- Follow-up: Conduct timely follow-up on outstanding claims and appeals, ensuring prompt resolution and payment.
- Collaboration: Work closely with supervisors, the denials team, insurance companies, and internal departments to resolve denied claims efficiently.
- Documentation: Maintain accurate records of denied claims, appeals, and resolutions in the billing system.
- Regulatory Compliance: Stay updated on healthcare regulations, insurance policies, and payer requirements to ensure compliance and prevent future denials.
- Reporting: Generate detailed reports on denial trends and recovery rates, providing insights for process improvements.
- Issue Resolution: Identify issues leading to underpayments and take corrective actions to ensure accurate billing and revenue recovery.
**Qualifications:**
- Education: Bachelor's degree in Healthcare Administration, Business, or a related field.
- Experience: A minimum of 5 years of industrial experience in hospital billing denials management and claims follow-up.
- Skills:
- Strong analytical and problem-solving abilities.
- Proficient in billing software and Microsoft Office Suite, particularly Excel and Word.
- Familiarity with medical terminology, CPT, ICD-10 coding, and payer policies.
- Excellent verbal and written communication skills.
- Strong attention to detail and ability to work independently.
**Work Environment:**
Fast-paced hospital billing environment with regular interaction with insurance companies, billing teams, and internal departments. Opportunities for professional development and process improvement involvement.
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