Accounts Receivable Specialist – Oral Surgery

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HighFive Healthcare

WebsiteLinkedInAlle Stellen

501 - 1000 Mitarbeiter

💼 Beratung

📣 Marketing

🏥 Gesundheitswesen

Consulting • Marketing • Healthcare

Sie sind bereits auf dem Höhepunkt Ihrer Leistungsfähigkeit; wir helfen Ihnen einfach, die Messlatte höher zu legen.\n\nWir bringen über 60 Jahre Erfahrung im Gesundheitswesen und ein Team, das die Grenzen des Machbaren erweitert. Von Abrechnung über Marketing, Compliance bis hin zu Wartung – wir sind das Schweizer Taschenmesser des Gesundheitsmanagements und bieten eine völlig neue Ebene der Zusammenarbeit.\n\nUnser Partnerschaftsvertrag ist einfach: Sie kümmern sich um Ihre Patienten und wir erledigen den Rest.

Beschreibung

• Investigate, appeal, and resolve denied or rejected claims by insurance payors. • Work with insurance companies to clarify discrepancies and ensure proper reimbursement. • Review and assess Explanation of Benefits (EOBs) at the claim level to determine issues. • Determine root cause of any billing related or claim submission issues to prevent recurrence. • Make corrections to claims based on denials and rebill utilizing standardized process and procedures. • Follow up with unresolved claims through system resources, clearinghouse, payer portal or call to the payor, when necessary. • Assess whether an appeal is required for a claim denial. • Track appeals to ensure timely payment and resolution. • Spot recurring patterns in denials and report them to management for further analysis and action. • Effectively communicate both verbally and in writing with team members, payors, patients, and other relevant parties. • Keep up to date with internal processes, industry standards, and government regulations relevant to denial management to ensure compliance and best practices. • Participate in or take on special projects or additional duties as required by the team or management. • Meet or exceed required accounts per day to meet HighFive and provider’s expectations. • Achieve department goals for net collection rates and the resolution of denied claims, including those successfully paid or overturned.

🎯 Anforderungen

• Oral Surgery billing experience required. • Denial/Claim OR AR Experience with TMJ (temporomandibular joint/orthognathic surgery) • High school diploma or equivalent; associate or bachelor’s degree in healthcare, business, or a related field preferred. • Minimum of 2 years of experience in healthcare billing and accounts receivable. • Knowledge of medical insurance plans, billing procedures, and healthcare reimbursement processes. • Proficiency with Electronic Health Record (EHR) systems and billing software. • Dental billing experience preferred but not required. • Working knowledge of excel and system workflows. • Prior experience with mid or large-scale healthcare business office of 100 or more providers preferred. • Strong attention to detail with the ability to accurately review and process claims. • Excellent communication and problem-solving skills. • Ability to work independently and manage multiple tasks simultaneously. • Knowledge of HIPAA and other healthcare compliance regulations.