Accounts Receivable Escalation Specialist

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Medsuite Inc

WebsiteLinkedInAlle Stellen

1 - 10 Mitarbeiter

🏥 Gesundheitswesen

⚕️ Krankenversicherung

☁️ SaaS

Healthcare • Healthcare Insurance • SaaS

Medsuite Inc. ist eine digitale Plattform, die darauf abzielt, das Gesundheitsmanagement zu optimieren und die Patientenversorgung zu verbessern. Sie bietet Gesundheitsdienstleistern Werkzeuge, um Patientenakten, Termine und Kommunikation effizient zu verwalten und gleichzeitig benutzerfreundlichen Zugang sowohl für Patienten als auch Anbieter zu gewährleisten.

Beschreibung

• The Accounts Receivables Escalation Specialist are primarily responsible for analyzing collections, resolving non-payables, and handling bill inquiries for more complex issues • AR Representatives are responsible for insurance payer follow-up ensuring claims are paid according to client contracts • Complies with all applicable laws regarding billing standards • Follows up on claim rejections and denials to ensure appropriate reimbursement for our clients • Process assigned AR work lists provided by the manager in a timely manner • Write appeals using established guidelines to resolve claim denials with a goal of one contact resolution • Identified and resolved denied, non-paid, and/or non-adjudicated claims and billing issues due to coverage issues, medical record requests, and authorizations • Recommend accounts to be written off on Adjustment Request • Reports address and/or filing rule changes to the manager • Check the system for missing payments • Properly notates patient accounts • Review each piece of correspondence to determine specific problems • Research patient accounts • Reviews accounts and determines appropriate follow-up actions (adjustments, letters, phone insurance, etc.) • Processes and follows up on appeals • Files appeals on claim denials • Scan correspondence and index to the proper account • Inbound/outbound calls may be required for follow-up on accounts • Respond to insurance company claim inquiries • Communicates with insurance companies about the status of outstanding claims • Meet established production and quality standards as set by Ventra Health • Performs special projects and other duties as assigned

🎯 Anforderungen

• High School Diploma or GED • At least one (1) year in the data entry field and one (1) year in medical billing and claims resolution preferred • AAHAM and/or HFMA certification preferred • Experience with offshore engagement and collaboration desired • Intermediate level knowledge of medical billing rules, such as coordination of benefits, modifiers, Medicare, and Medicaid, and understanding of EOBs • Become proficient in the use of billing software within 5 weeks and maintain proficiency • Ability to read, understand and apply state/federal laws, regulations, and policies • Ability to communicate with diverse personalities in a tactful, mature, and professional manner • Ability to remain flexible and work within a collaborative and fast-paced environment • Basic use of a computer, telephone, internet, copier, fax, and scanner • Basic touch 10 key skills • Basic Math skills • Understand and comply with company policies and procedures • Strong oral, written, and interpersonal communication skills • Strong time management and organizational skills • Strong knowledge of Outlook, Word, Excel (pivot tables), and database software skills.

🏖️ Vorteile

• As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan • Help Us Grow Our Dream Team — Join Us, Refer a Friend, and Earn a Referral Bonus!