Note: The job is a remote job and is open to candidates in USA. HighFive Healthcare is seeking a Part-time Accounts Receivable Specialist to manage the insurance accounts receivable process for Huntsville Oral Surgery. The role involves submitting claims, following up on unpaid claims, and resolving billing discrepancies with payors and patients.

Responsibilities

• 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

Skills

• Oral Surgery billing experience required
• High school diploma or equivalent
• 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
• Working knowledge of excel and system workflows
• 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
• Associate or bachelor's degree in healthcare, business, or a related field

Company Overview

• HighFive Healthcare optimize dental practices by centralizing operations, leveraging technology to reduce costs associated with dental care. It was founded in 2018, and is headquartered in Homewood, Alabama, USA, with a workforce of 501-1000 employees. Its website is https://www.high5health.com.