Medical Billing & AR Recovery Specialist

Job Description

REQUIREMENTS

• Strong knowledge of medical coding including ICD-9, ICD-10, CPT codes, and DRG classifications.
• Expertise in medical billing processes, claim submission procedures, and insurance reimbursement protocols.
• Proven experience in AR recovery strategies with a focus on medical collections and denial management.
• Familiarity with EMR/EHR systems for accurate data entry and record keeping.
• Excellent understanding of medical terminology, medical records management, and healthcare documentation standards.
• Ability to analyze complex claims data using ICD coding systems to identify errors or discrepancies.
• Effective communication skills for liaising with insurance companies, healthcare providers, and patients to resolve billing issues efficiently.

RESPONSIBILITIES

• Prepare and submit accurate insurance claims using ICD-9, ICD-10, CPT coding, and DRG (Diagnosis-Related Group) classifications to ensure proper reimbursement.
• Review medical records and documentation to verify coding accuracy and compliance with payer requirements.
• Follow up on unpaid or denied claims promptly through effective appeals and resubmissions to maximize recovery.
• Manage accounts receivable by tracking outstanding balances, initiating collections efforts, and negotiating payment plans when appropriate.
• Collaborate with medical offices and providers to clarify billing discrepancies and ensure complete, correct medical records for billing purposes.
• Utilize EMR (Electronic Medical Records) and EHR (Electronic Health Records) systems efficiently for data entry, claim processing, and record management.
• Maintain detailed documentation of all billing activities, correspondence, and collection efforts to ensure transparency and audit readiness.

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