Strivant Health partners with physician practices to improve revenue cycle operations by optimizing people, processes and technology. We provide best in class Medical Billing, Collections, Call Center, Credentialing and Analytics that are all designed to focus on maximizing our provider clients’ revenue. This allows our client providers to stay focused on the practice of medicine, rather than the business of medicine. We have worked with over 4,000 providers representing 25 different specialties and over 30 technology platforms in our 20+ years of business.
LOCATION: This position is 100% remote
Hours: Monday - Friday. 9:00 AM-5:30 PM, full-time, Eastern Time
Status: Temporary - 6 month project, with consideration to convert to regular hire
AR Specialist - Physician Revenue Cycle Management (RCM)
The primary purpose of the Accounts Receivables team is to pursue reimbursement of services rendered and achieve accounts receivable resolution. This team works through open accounts receivables (denials and delinquent accounts) by actively calling payer organizations or utilizing web-based connectivity.
The Accounts Receivables Specialist performs collection follow-up steps with insurance carriers and/or patients regarding open accounts receivable and/or delinquent accounts to result in maximum cash collections for our clients. Specific tasks include resolving insurance carrier denials, appealing claims, contacting carriers on open accounts and responding to insurance carrier correspondence and/or inquiries. This position holds additional duties with respect to research, client contact and participation in root cause analysis and identifying process improvements. This role will have exposure to multiple practice management systems.
- Responsible for all aspects of insurance follow up and collections, including making telephone calls, accessing payer websites.
- Maintains a large dollar inventory desk as well as serve as just-in-time staffing, working inventory for team members that may be absent or backlogged.
- Identify root cause issues for denials; categorize denial reasons and coordinate with client and/or with management to ensure process improvements are completed
- Owns client's performance and ensure consistent and timely communication for issues identified.
- Effectively resolve complex or aged inventory, including payment research, payment recoups with minimal or no assistance necessary.
- Accurately and thoroughly document the pertinent collection activity performed.
- Review the account information and necessary system applications to determine the next appropriate work activity.
- Verify claims adjudication utilizing appropriate resources and applications. Initiate telephone or letter contact to patients to obtain additional information as needed.
- Perform appropriate billing functions, including manual re-bills as well as electronic submission to payers.
- Edit claims to meet and satisfy billing compliance guidelines for electronic submission.
- Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory.
- Provide technical assistance, coaching and training to other team members.
- Provides periodic quality assurance checks.
- Stay informed of changes with the procedures and laws for the specific insurance carriers or payers.
- Assist in special projects assigned by management.
- Participate and attend meetings, training seminars and in-services to develop job knowledge.
- Respond timely to emails and telephone messages from the staff, management, and the client.
- May assist with claim edit, charge entry, cash research and payment posting, as needed.
- Effectively communicate issues to management, including payer, system or escalated account issues as well as develop solutions.
- Performs other related duties as required or requested.
- High school diploma or equivalent
- A minimum of 3 years’ experience in physician collections with complex denials and appeals management
- Prior experience translating denial trends into process improvements results with little supervision
- Previous experience with medical billing systems required.
- Knowledge of CPT, ICD-9/10 and HCPCS codes
- Sharp intelligence of government payers and other commercial/managed care carrier rules and processes in a professional billing environment
- Attention to detail with the ability to identify/resolve problems and document the outcome
- Strong written and verbal communication skills
- Excellent analytical and problem-solving skills
- Ability to multi-task and recognize trends to effectively work A/R
- Solid skill with Microsoft Office applications: Word, Excel
- Initiative to learn new tasks and the ability to apply acquired knowledge to future duties
- Flexibility, adaptability, and accountability are necessary for optimum client results
We are looking forward to reviewing your resume!
No agencies, please!
Search tags: Customer Service Rep, Patient Access, Patient Financial Rep, Scheduling Rep, Revenue Cycle, RCM, Accounts Receivables Rep, Patient Account Rep, Patient Service Rep, Account Rep, Medical Coding, Medical Credentialing, Medical Referrals, Medical Billing, Physician
Job Type: Full-time