A/R Specialist (REMOTE)

Job Description

Position Summary: Reporting to the Revenue Cycle Supervisor, the A/R Specialist provides end-to-end revenue cycle responsibilities and account management. This individual will work in multiple systems based on the client’s needs. We are looking for an ambitious individual to impact and expand our rapidly growing team. As a Revenue Cycle Specialist, you will play a crucial role in supporting our clients.

Key Performance Indicators: The KPI’s that will be used to measure the performance of the individuals in this role include, but are not limited to:

1) Production

2) Quality

3) Resolution %

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Ensures compliance with all federal, state, local and internal policies, and procedures.
• Responsible for submitting claims and ensuring follow-up on outstanding claims.
• Denial management to ensure an efficient process and ultimately resolution.
• Ensures information obtained is complete and accurate.
• Collaborates with internal departments and external providers on utilization management of authorizations.
• Ensures up-to-date documentation in billing software.

Job Competencies

• Understand essential functions Within the areas of Revenue Cycle Department:
• AR Follow-up
• Maintain current knowledge of billing rules for providers (hospital and physicians) and Insurance Providers
• Reports discrepancies, admission errors, and coding questions to proper departments for ongoing process improvement.
• Prioritize insurance aging reports to identify unpaid insurance claims.
• Ability to work with Insurance Providers to drive resolutions via portals and telephone communication.
• Identify, bill, and follow-up on unpaid secondary or tertiary claims within assigned insurances.
• Follow policies and procedures for submitting appeals.
• Ensures all claims are resolved in a timely manner.

• Ensure all appeals are conducted as appropriate with Insurance Providers
• Enhances billing department and organization reputation by accepting ownership for accomplishing new and different requests, exploring opportunities to add value to job accomplishments.

Job Qualifications, Skills, Abilities, Requirements: To perform this job successfully, an individual must be able to perform each essential duty to our current standards and meet expected KPI’s. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Knowledge of healthcare billing and reimbursement strategies.
• Ability to effectively communicate both orally and in writing.
• Demonstrates the ability to plan and prioritize work, coordinate with others, and use time productively.
• Provide excellent customer service to both internal and external customers.
• Ability to support HIPAA privacy rules and maintain strict confidentiality.
• Self-Motivated with the ability to function as a team player and as an individual contributor.
• Ability to adapt to change and be flexible.
• Engages in all time sensitive tasks with level or urgency.
• 2+ years of relevant experience in finance/healthcare, medical billing & reimbursement.
• Experience with State and Federal (Medicare, Medicaid) and private insurance billing portals.
• Proficiency in Microsoft products including Word and Excel.
• Proficient in Epic, Meditech, Salesforce a plus

Earnings

$24.00 hourly

Category

Medical Billing & Coding