The future is already here.
It's just not evenly distributed yet.

The Revenue Cycle A/R Specialist (6 month Temporary) will take ownership of critical billing processes and help drive cash collections. The role is responsible for maximizing reimbursement from various insurance plans by resolving complicated denials, underpayments, billing errors and other claim issues. This role will also collaborate closely with internal stakeholders including the Contracting & Credentialing team, Billing Specialists, Financial Coordinators and the Clinical team.

**Type: 6 month Temporary position with the potential to become a permanent role**

Location: Remote

Schedule: Flexible M-F schedule, Full time (40 hrs)

Target Pay Range: Starting at $40.00 per hr - Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data.

You can expect to:

• Responsible for the day-to-day processes to manage health services claims through the claim lifecycle, including resolution of claim holds in the billing system (i.e. pre-bill claim holds, clearinghouse rejections, insurance follow-up, claim corrections and resubmissions).
• Work assigned lists of outstanding claim balances and patient accounts with multifaceted issues across different payers and patients.
• Perform actions towards remediation of outstanding balances including, but not limited to, in-depth research, appeals, rebilling, obtaining insurance authorizations or referrals, coordination of benefits (COB), correcting coding, calling the payer and utilizing payor portals.
• Performs root cause analysis and identifies denial trends. Demonstrates good judgment in escalating identified root causes and trends to leadership to ensure timely resolution.
• Communicates effectively with the Billing Specialists to handle the accurate and timely resolution of coding-related claim edits and appeals.
• Ensure proper documentation is attached to corrected claims, if needed.
• Ensure timely follow up on zero pay claims utilizing Zero Pay Worklist in Athena.
• Run routine underpayment analysis for assigned payors using Athena’s Payment Mismatch Wizard, ensuring payors are adhering to contract terms.
• Effectively communicate with insurance payors and escalate appropriately within these entities to resolve claim issues.
• Initial claims tracking and troubleshooting for newly contracted payors.
• Assist Financial Coordinators with resolution of complex insurance claim-related inquiries.
• Responsible for Athena Unpostable Worklist, Correspondence Dashboard, and Non-Athena Remittance Worklist.
• Partner with the Contracting and Credentialing team to resolve tasks on Athena’s Enrollment Worklist.
• Payment Posting, as needed.
• Prepare and process insurance refund requests, as required.
• Assist with managing patient and payer credit balances.
• Assist with special billing projects, as needed.
• May be responsible for cross-coverage or additional support of the Billing Specialist team.
• Regular and predictable attendance is expected.
• All other duties as assigned.

Qualities we're looking for:

• 4+ years of revenue cycle, denial management, or medical billing experience.
• Strong command of health insurance reimbursement, claim adjudication processes, plus working knowledge of billing and collection best practices.
• Ability to manage relationships with various insurance payers.
• Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement.
• Detail oriented with strong organizational skills.
• Experience in billing specifically in patient benefit details and reconciling insurance Explanation of Benefits.
• Consistent access to a private work environment with high speed internet and professionally appropriate surroundings for frequent video conferencing and a workstation setup conducive to remote work needs.

This is a full-time (40hrs per week) remote position.

#LIRemote