Senior Payer Accounts Receivable Specialist

10 hours ago

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knownwell

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Healthcare Insurance • Wellness

knownwell is a healthcare provider offering comprehensive, empathetic primary care and obesity medicine services. The company is dedicated to reshaping healthcare to provide unbiased, shame-free care for individuals of all sizes. They emphasize patient-centered care, focusing on both primary and metabolic health, and offer a range of services including remote patient monitoring, nutrition counseling, health coaching, and prescription medications. knownwell operates with a mission to combat weight bias in healthcare and create personalized care plans for their patients.

11 - 50 employees

⚕️ Healthcare Insurance

🧘 Wellness

💰 $20M Series A on 2023-12

📋 Description

• Monitor overall payer A/R performance, including aging trends, denial rates, and collection metrics. • Serve as the primary liaison between internal leadership and outsourced billing partners for payer-related workflows. • Review and escalate unresolved or systemic claim issues (e.g., underpayments, incorrect denials, recurring rejection codes). • Identify and prioritize high-value or at-risk accounts for targeted resolution. • Process and reconcile payments, EOBs, and ERAs, accurately posting to patient accounts and the A/R system. • Review payer denials and correspondence to identify patterns and recommend process improvements. • Work with coding, charge entry, and credentialing teams to resolve root causes of denials or payment delays. • Track payer policy updates and reimbursement changes that impact claim outcomes. • Coordinate corrected claims, appeals, and retroactive adjustments as needed. • Process and reconcile payments, EOBs, and ERAs, accurately posting to patient accounts and the A/R system.

🎯 Requirements

• 4+ years of experience in healthcare payer A/R or medical billing, preferably in an outpatient or multi-state environment. • Strong understanding of EOBs, CARC/RARC codes, denial management, and payer reimbursement methodologies. • Prior experience collaborating with or managing outsourced billing teams strongly preferred. • Athenahealth experience is a plus. • Associate’s or Bachelor’s degree preferred; equivalent RCM experience considered. • **Technical skills: **Proficiency in using electronic health record software (Athena preferred) and other relevant computer applications. • **Professionalism: **Commitment to providing exceptional customer service and representing the company in a professional manner.

🏖️ Benefits

• 💻 Fully remote opportunity • 🩺 Medical, dental, and vision insurance • 📈 401K retirement plan with company match • 🏝️ Up to 20 days of PTO per year + company holidays • 👶 Up to 14 weeks of parental leave (12 for non-birthing parents) • 🏡 Annual work from home stipend for remote employees