Highlights
Perform claim denial follow-up, research unpaid and underpaid claims, identify billing issues, and pursue available options to obtain payment. This role will focus heavily on insurance claim denial follow-up, unpaid claims, payment recovery, billing issue resolution, and account management.
Numbers & Facts
| Location | San Antonio, TX |
| Industry | Staffing/Employment Agencies |
| Company Size | 100 to 499 employees |
| Website | https://www.prg-usa.com/ |
Description
Our client is seeking an experienced Medical Accounts Receivable (AR) Specialist to manage all aspects of medical AR collections for a physician medical group. This role will focus heavily on insurance claim denial follow-up, unpaid claims, payment recovery, billing issue resolution, and account management.
Key Responsibilities
- Manage assigned medical accounts receivable and insurance payer follow-up to ensure timely payment of outstanding claims.
- Perform claim denial follow-up, research unpaid and underpaid claims, identify billing issues, and pursue available options to obtain payment.
- Follow up on zero-payment Explanation of Benefits (EOBs) and determine appropriate next steps for claim resolution.
- Monitor accounts for delinquent payments and use appropriate collection techniques to maintain current AR.
- Research and resolve patient billing inquiries, insurance issues, and account discrepancies.
- Professionally communicate with patients, insurance companies, and clinic staff regarding account balances, claims, payments, and billing concerns.
- High School Diploma or GED.
- 2+ years of medical billing and/or collections experience, preferably within a physician practice, medical group, hospital, or other healthcare setting.
- Knowledge of government insurance programs, including Medicare Part B and C, Medicaid and associated Medicare Advantage plans, and TRICARE.
- Knowledge of commercial insurance plans, including PPO, HMO, EPO, and HRA.
- Working knowledge of CPT, HCPCS, and ICD-10 coding.
- Understanding of HIPAA guidelines and the importance of protecting patient information.
About Company
Established in 2001, Peyton Resource Group is a solution-based staffing company that matches businesses with top talent for short-term, long-term or permanent needs.
People are a business’s most valuable asset. Peyton Resource Group is dedicated to helping companies find the best talent, matching professionals with jobs where they will thrive.
With locations in Dallas/Fort Worth, San Antonio and Austin, we are available to serve your staffing needs throughout Texas and across the country.