Avenue360 Health and Wellness

Our Compensation Package Includes:

• Generous Paid Time Off- (11 paid holidays per year, 2 Floating Holidays per year, 14 paid Vacation days per year, 4 hours per month of accrued Sick days)
• Medical, Dental, and Vision
• 401K match up to 4%
• Company paid Life Insurance
• Company paid Short Term and Long-Term Disability
• Employee Assistance Program

Overview: The A/R Specialist is responsible for the company’s third-party medical claims processing and assisting patients and office staff with questions on insurance claims, authorizations, statements, and other billing issues. This position will submit and follow-up on medical claims for Managed Care Organization (MCO), Medicaid, Medicare, Other Federal, Private Insurance, and Workers Compensation.

Duties and Responsibilities:

• Work unpaid claims in follow-up work queues.
• Rebills/appeals claims within 30-45 days of denial date.
• Provide insurance companies with needed medical records or documents when requested.
• Identifies payer trends or issues and reports to leadership for resolution.
• Bill patients for non-covered services.
• Bill secondary and tertiary insurances after primary payment.
• Assist patients with self-pay balances.
• Always maintain proper work standards in productivity and quality.
• Other tasks as assigned by the Director, Revenue Cycle and Billing.

Education, Experience, Licensure/Certification and Skills/Abilities Related Requirements:

• High School Diploma required.
• 2 years billing experience
• 5 years collection experience
• FQHC collection experience preferred

Continuing Education and Training Requirements:

Participates in trainings required by the funding source and/or as required by licensure.

JOB CODE: Req 1669