A / R Billing Specialist - Atlanta, GAAtlanta, GA

A / R Billing Specialist - Atlanta, GA

Position Summary :

PhyNet Dermatology is seeking skilled and motivated Billing Specialists to join our team. If you excel at insurance follow-up, denials management, and claims resolution, we encourage you to apply today. As a Denials Specialist, you will play a critical role in ensuring timely claims resolution and maintaining compliance with payer guidelines.

Location : Atlanta, GA

Hybrid Work Schedule Work on-site Monday through Wednesday and remotely Thursday and Friday.

Essential Functions :

• Monitor commercial, government, and specialty payer claims to ensure timely follow-up and resolution.
• Maintain a comprehensive understanding of payer guidelines, policies, and requirements related to denials and appeals.
• Update demographic and account information as needed to ensure clean claim submissions.
• Meet or exceed productivity and accuracy benchmarks set by management.
• Review medical records, provider notes, and Explanation of Benefits (EOBs) to facilitate appeals or resolve accounts.
• Initiate and manage appeals to insurance companies to resolve claims effectively.
• Handle payer correspondence, ensuring all required information is submitted promptly for claim processing.
• Analyze claim coding (CPT, ICD-9 / 10, HCPCS) to ensure accurate billing practices.
• Conduct detailed account follow-ups, analyze problem accounts, and document resolution efforts.
• Audit accounts for payment accuracy, contractual adjustments, and patient balances.
• Identify and report payer trends or recurring issues to management for resolution.
• Collaborate with patients, physician offices, and insurance companies to obtain additional information for claim processing.
• Generate patient responsibility statements and utilize insurance websites to address and resolve claims.
• Ensure proper documentation of all follow-up actions in the accounts receivable system.
• Maintain regular attendance and demonstrate a strong commitment to teamwork and professionalism.

Knowledge, Skills & Responsibilities :

This role requires a proactive, dependable, and detail-oriented individual with the ability to manage multiple tasks in a dynamic healthcare environment. The ideal candidate demonstrates a strong commitment to patient care and operational excellence.

Physical and Mental Demands :

The physical and mental demands described below are representative of those required to perform this job successfully. Reasonable accommodations may be made for individuals with disabilities :

Note : This job description is intended to provide a general overview of the role. Additional responsibilities may be assigned, or duties modified by the department supervisor based on operational needs.