About Protouch Medical Billing
Protouch Medical Billing, a subsidiary of Protouch Staffing, is a healthcare Revenue Cycle Management (RCM) company built on decades of experience in the healthcare industry. Leveraging deep expertise in healthcare operations, compliance, and patient care, we help healthcare providers optimize their financial performance through tailored RCM solutions. Our experienced team specializes in medical billing, coding, claims management, and compliance, utilizing advanced technology and industry best practices to streamline revenue cycles for healthcare providers ranging from individual clinics to large hospitals.
Position Summary: The AR Specialist follows up on unpaid, denied, rejected, and underpaid professional claims. The position documents actions, resolves assigned accounts, and escalates issues requiring advanced payer, appeal, regulatory, or client intervention.
Job Specification & Preferences
- Blue Cross website,
- Preferably if they have worked in Texas, New York, Alabama, Louisiana, or Florida.
Required Experience: 3 to 5 years.
Essential Responsibilities
- Review assigned AR inventory by payer, aging, balance, and priority.
- Research claim status through payer portals and telephone follow-up.
- Correct and resubmit eligible claims.
- Work assigned rejections and denials.
- Obtain missing information and documentation.
- Identify filing-limit, authorization, eligibility, coding, and billing issues.
- Recognize potential out-of-network underpayments.
- Prepare or support reconsiderations and appeals.
- Record clear account notes and appropriate follow-up dates.
- Escalate systemic payer problems and high-risk accounts.
- Meet productivity, quality, and resolution standards.
Required Qualifications
- At least two years of U.S. medical billing or AR experience
- Professional-claim follow-up experience
- Working knowledge of denials, appeals, timely filing, and payer processes
- Experience using payer portals and billing systems
- Strong research, documentation, and problem-solving skills
- Clear written and spoken English
Preferred Qualifications
- Emergency medicine or hospital medicine AR experience
- Out-of-network billing and underpayment experience
- No Surprises Act exposure
- Experience with aged inventory
Key Performance Indicators
- Accounts worked
- Dollars resolved
- Cash attributable to AR activity
- Aging movement
- Denial-resolution rate
- Account-note accuracy
- Follow-up timeliness
- Quality-audit score
