AR Team Lead

🔥 13 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟠 Senior

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Healthrise

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

⚖️ Legal

📦 Logistics

Healthcare • Legal • Logistics

Healthrise is a company dedicated to providing comprehensive healthcare solutions, focusing on revenue cycle management, electronic health record (EHR) services, and strategic consulting. With over a decade of experience, Healthrise assists health systems nationwide in achieving operational and financial success through tailored strategies. Their team of experts partners with healthcare organizations to tackle complex operational challenges and enhance efficiency, ensuring both patient and financial outcomes are optimized.

📋 Description

• Perform day-to-day payment resolution activities within Hospital and/or Medical Group partner revenue operations • Receive, analyze, and appeal denials, including clinical denials • Review, research, and resolve payment delays and variances from rejected or denied claims, overpayments, and underpayments • Work hospital billing Medicare denials and underpayments using Medicare rules, edits, and appeal processes • Work California commercial, managed care, and government payor accounts using payor-specific rules, contracts, fee schedules, and appeal requirements • Process payments according to contracts and policies for timely and accurate liability resolution • Investigate overpayments and underpayments to optimize reimbursement • Resolve claims, conduct formal account reviews, identify lost charge recovery, and document delays and payment variances • Follow up with patients and payers, refile accurate claims, and document findings • Maintain knowledge of applicable federal, state, and local laws and regulations, including Medicare and California requirements • Coordinate with clinical departments on clinical denial appeals • Collaborate with Patient Access and stakeholders to resolve authorization issues • Communicate with physicians, office staff, hospital departments, patients, and payers • Track and report denial types and root causes; recommend process improvements • Prepare reports on trends, outcomes, and claim activity; interpret data and review findings with the supervisor • Request write-offs, transfers, allowances, and reversals; recommend accounts for collection-vendor transfer • Document all actions in the patient accounting system • Serve as first-line support for AR Specialists, troubleshoot issues, and escalate complex cases • Review team members’ work for accuracy and compliance; provide coaching and real-time feedback • Track productivity and quality metrics and communicate performance trends to leadership • Support onboarding and training of new AR Specialists • Identify recurring issues and payer trends and communicate insights for process improvement • Cross-train in various functions and perform other assigned duties

🎯 Requirements

• High school diploma or Associate degree in Accounting, Business Administration, or a related field • Minimum of two (2) years of revenue cycle experience in a hospital, clinic, insurance company, managed care organization, or similar healthcare financial setting, or an equivalent combination of education and experience • Hands-on experience working HB Medicare accounts, including denials, appeals, and payment variance resolution • Experience working with California payors, including Medi-Cal, California commercial and managed care plans, and delegated medical group/IPA arrangements • Familiarity with California payor contracts, billing rules, and appeal processes • Experience using Epic • Excellent written and verbal communication and organizational skills • Strong interpersonal and customer service skills • Attention to detail, accuracy, and time management • Basic proficiency in Microsoft Office (Outlook, Word, PowerPoint, Excel) • Comfortable working in a collaborative, shared leadership environment • Preferred: experience in a complex, multi-site environment • Preferred: previous experience with Global Partner vendors • Preferred: completion of regulatory/mandatory certifications • Preferred: prior experience coaching, training, or leading a team

🏖️ Benefits

• Fully remote work arrangement

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