AR Recovery Analyst III – Medicaid

🔥 2 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 10%

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FinThrive

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

☁️ SaaS

🤖 Artificial Intelligence

💰 $1M Series A on 2010-02

Healthcare • SaaS • Artificial Intelligence

FinThrive is a healthcare revenue cycle management (RCM) technology company that provides AI-powered, data-intelligence solutions to hospitals, health systems, ambulatory and physician practices, payers and life sciences organizations. Its FinThrive Fusion platform unifies siloed revenue-cycle data to enable predictive analytics, agentic AI workflows, and operational intelligence. Product offerings include patient access, revenue integrity (charge capture and compliance), revenue optimization (claims, denials prevention, payment accuracy), enterprise analytics and learning content designed to improve cash flow, reduce denials and streamline revenue operations. FinThrive positions itself as a SaaS provider delivering AI and automation capabilities to improve financial performance and operational efficiency across the healthcare revenue cycle.

📋 Description

• Learn and understand the ARO platform and available resources • Manage assigned accounts from start to finish in a timely manner • Call healthcare insurance companies, affiliates, and providers to resolve contract or payment issues • Analyze contract, billing, cash costing, pricing, and collections in compliance with regulations, policies, and procedures • Investigate insurance payments that deviate from expected payment • Collaborate with leadership and team members to confirm, challenge, or provide trends and solutions • Document research outcomes and work performed on accounts or subaccounts • Use system status codes, follow-up, and mark-ahead responses accurately • Escalate items to senior staff or management when appropriate • Validate bulk underpayment or denial trends • Follow up on mid-dollar balances according to project criteria • Create appeals and patient or payer correspondence • Maintain compliance with regulatory guidelines, including HIPAA • Mentor Rep I associates • Manage moderately complicated insurance denials and underpayments using Rubixis AR Follow Up software

🎯 Requirements

• 5+ years of experience with healthcare insurance billing, follow-up, and collection in a hospital, clinical, or BPO vendor environment • Proven track record of success in reimbursement and follow-up • Knowledge of Medicaid payer rules and processes, including interpreting denial reasons, submitting appeals to Medicaid payers, and accessing Medicaid portals • Basic understanding of HIT systems such as EPIC, Paragon, Zirmed, or other billing systems • Ability to resolve higher-complexity denials and underpayments • Ability to understand and use payer contract language in calls with payers • Basic understanding of the healthcare revenue cycle in a hospital or clinical setting • Intermediate to advanced understanding of insurance billing, reimbursement, and follow-up processes • Familiarity with different payer types for claims processing and adjudication • Ability to use medical billing terminology, including UB/1500 claim types, CPT, ICD, DRG codes, and EOB/RA • Proficient understanding and interpretation of payer correspondence • Excellent written and verbal communication • Proficiency with basic mathematical functions • Problem-solving and organizational ability • Able to consistently maintain or exceed minimum average daily productivity and quality after 90 days • Understanding of Patient Accounting systems/EMR • Skills with MS Office Word and Excel applications • Degree in a related field • Certification in billing or medical coding • 5+ years of experience in UB-04 follow-up and/or contract/reimbursement analysis, including pricing and reimbursement variance investigations • 5+ years of experience with Medicaid processes and systems • Compliance with HIPAA, FCRA, GLBA, and other applicable laws • Commitment to integrity, ethics, confidentiality, and FinThrive’s core values

🏖️ Benefits

• FinThrive perks and benefits are referenced, with current offerings available at finthrive.com/careers-benefits • Equal Opportunity Employer • Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions • Self-development and continuous feedback and learning opportunities • Required compliance training