Billing & A/R Specialist

OnPoint Medical Group is a physician-led network of skilled Primary and Urgent care providers who are committed to expanding access to quality healthcare in the most effective and affordable manner possible.

Our "Circle of Care" has one primary goal – to ensure the health and wellness of members and their families. We do this by providing access to a comprehensive menu of medical services from one unified physician group in their neighborhoods. With doctors, nurses, specialists, labs and medical records all interlinked and coordinated, patient care has never been in better hands.

Billing and A/R specialist requirements include full revenue cycle duties including submitting a clean claim and/or assisting with said submission, verify contractual payment is received and/or appealing a denial, answering patient phone calls and reviewing patient statements, working A/R.

OnPoint Medical Group is seeking an outstanding Billing & Accounts Receivable (A/R) Specialist to join our growing team. This is an excellent opportunity to become part of a physician-led organization committed to delivering high-quality, accessible, and affordable healthcare. This position is located on-site in the Highlands Ranch, CO corporate office.

Position Summary

The Billing & A/R Specialist is responsible for supporting all aspects of the revenue cycle, including claims submission, payment review, denial follow-up, appeals, patient account support, and accounts receivable management. This role requires strong attention to detail, knowledge of medical billing processes, and the ability to communicate effectively with patients, providers, and insurance carriers.

Essential Duties and Responsibilities

The following statements describe the essential functions of this role. They are not intended to be an exhaustive list of all duties, responsibilities, or qualifications required. OnPoint Medical Group reserves the right to modify job responsibilities at any time.

Accounts Receivable Collections and Management

• Work directly with insurance companies, healthcare providers, and patients to ensure claims are processed accurately and paid in a timely manner.
• Submit clean claims or assist with claim submission as needed.
• Verify contractual payments and investigate payment discrepancies.
• Review, correct, and appeal unpaid or denied claims.
• Run and analyze A/R reports.
• Work unpostables, denials, and claim worklists in accordance with Athenahealth best practices.
• Respond to patient calls regarding billing questions and account statements.
• Review and resolve outstanding accounts receivable balances.

Productivity Expectations

• Resolve a minimum of 37claims per dayfrom assigned claim worklists.
  • Goal may vary based on payor type, projects, other assignments etc.
• Maintain accounts receivable balances at less than 180 days outstanding.
• Answer patient billing calls based on assigned phone responsibilities and minimize voicemail backlogs.

Compliance and Policies

• Perform duties in accordance with the standard Billing Complianceand Billing Guidelines.
• Maintain and follow strict privacy, confidentiality, and safety standards.
• Comply with all applicable governmental and regulatory requirements, including:
  • HIPAA
  • OSHA
  • PCI DSS