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.

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