Medical Billing & A/R Specialist

Prepare, submit, review, and track insurance claims for timely and accurate reimbursement.

Manage approximately 1,200–1,300 insurance claims per month as part of the billing team, with volume expected to grow.

Monitor claim status and follow up with insurance payers on outstanding claims.

Identify and resolve claim issues, discrepancies, and unpaid balances.

Prepare and submit corrected claims and insurance appeals when needed.

Work directly with insurance companies and use payer portals to verify claim status, eligibility, benefits, and other account information.

Handle insurance correspondence and document relevant payer communications.

Manage assigned A/R accounts and take ownership of each account through resolution.

Follow up consistently on unresolved accounts and outstanding balances.

Maintain accurate documentation of the last action taken, next action required, and follow-up date for unresolved accounts.

Investigate payment discrepancies, denials, underpayments, and other reimbursement issues.

Assist with patient accounts receivable, including balance billing and patient balance follow-up.

Ensure unresolved accounts are actively worked and do not fall through the cracks.

Perform insurance eligibility and benefits verification.

Maintain a working knowledge of U.S. healthcare insurance verification processes.

Assist with insurance authorization processes and ensure required authorizations are properly tracked.

Identify potential authorization or eligibility issues that may affect reimbursement.

Handle secondary insurance claims and coordinate benefits when applicable.

Assist with workers' compensation claims and related billing processes.

Maintain accurate records of claims, payments, account status, and follow-up activity.

Work closely with the existing billing team to divide responsibilities based on experience and strengths.

Help improve and organize billing workflows and processes.

Support process improvements and administrative tasks related to the practice's revenue cycle.