Orthopaedic Medical Group of Tampa Bay is a fast-paced and well established orthopaedic practice with 9 locations, including an ambulatory surgery center. The Medical Accounts Receivable Specialist is responsible for knowing the full accounts receivable cycle. The primary responsibility of this role will be to follow up on unpaid and underpaid claims over 31 days old for our ambulatory surgery center.
The Medical Accounts Receivable Specialist will be responsible for documenting patient accounts with claim status, composing targeted appeals for claims that have either denied or not paid appropriately, and researching and reporting denial trends to management.

Job Duties:

• Reviews outstanding insurance claims and contacts carrier for resolution prior to patient billing.
• Contact patients for updated insurance information when necessary.
• Updates and re-bills as appropriate.
• Reviews all rejected claims and appeals when appropriate.
• Makes adjustments to patient accounts as required.
• Initiates refund requests when necessary.
• Work new and old surgery center AR; Work closely with payers, file and follow-up on appeals; work insurance denials and zero pays
• Work correspondence and credit balances
• Work high dollar claims; Commercial and government payors
• Answer incoming patient calls with billing related questions/take patient payments
• Make outbound patient calls with any account issues
• Maintains confidentiality of all patient and financial information.
• Adheres to company policy in maintaining an acceptable attendance/tardy record.

Qualifications:

• High School Diploma
• Minimum 1 year experience in medical billing and collections required
• 3+ years experience in Medical Accounts Receivable preferred
• Knowledge of reimbursement guidelines, CPT and ICD-10codes, payor contracts and plans.
• Excellent communication, organization, and computer skills.
• Detail and customer service oriented.
• We are looking for a candidate with a strong work ethic and excellent communication skills.

PHYSICAL REQUIREMENTS:

• Requires sitting and standing associated with a normal office environment.
• Manual dexterity needed for using a ten-key calculator and/or computer keyboard.
• Specific vision abilities include close vision, distance vision, depth perception and the ability to adjust focus.

• Reviews outstanding insurance claims and contacts carrier for resolution prior to patient billing.
• Contact patients for updated insurance information when necessary.
• Updates and re-bills as appropriate.
• Reviews all rejected claims and appeals when appropriate.
• Makes adjustments to patient accounts as required.
• Initiates refund requests when necessary.
• Work new and old surgery center AR; Work closely with payers, file and follow-up on appeals; work insurance denials and zero pays
• Work correspondence and credit balances
• Work high dollar claims; Commercial and government payors
• Answer incoming patient calls with billing related questions/take patient payments
• Make outbound patient calls with any account issues
• Maintains confidentiality of all patient and financial information.
• Adheres to company policy in maintaining an acceptable attendance/tardy record