Accounts Receivable Representative

🔥 5 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

💰 Accounts Receivable

🚫👨‍🎓 No degree required

👻 Ghost score 11%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Sage Clinical RCM, LLC

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2024

🏥 Healthcare

☁️ SaaS

🤝 B2B

Healthcare • SaaS • B2B

Sage Clinical RCM is a healthcare revenue cycle management company that combines proprietary technology with clinical and financial expertise to provide end-to-end RCM solutions—from patient access through financial close. The firm offers advisory services, revenue cycle management operations, technology adoption (including clinical documentation improvement and autonomous coding), workforce augmentation (coding, documentation, RCM, physician advisory), and analytics-driven platforms (Sage IQ: Validity and VERO) that use automation and AI to unify coding, documentation, vendor performance, compliance, and financial reporting for healthcare organizations.

📋 Description

• Handle billing, re-billing, post-payment review, account follow-up, and/or grievance preparation for assigned client EMR accounts receivable • Maintain accounts for specialized or multiple payers, including state and federal government programs, managed care, commercial, and other insurance groups • Partner with team members and health plans to facilitate appropriate and prompt claim payment • Review and scrub final billed initial claims for accuracy and completeness before payer submission • Calculate Tier, Outlier, DRG, and/or other fee-schedule-based reimbursement • Submit electronic and/or hardcopy claims with required attachments according to contract timely-filing criteria • Document account activity in the hospital/client system and The Q • Contact health plans by phone or website to determine claim status • Document follow-up actions and schedule additional review for unresolved accounts • Research and validate paid or partially paid claims against client contract expectations • Review denied, disallowed, or non-covered claims and charges and determine accuracy based on contract language • Resolve technical payer issues when warranted • Request adjustments and refunds according to client-specific procedures • Prepare appeals and documentation for authorization, coding, level-of-care, and/or length-of-stay denials • Follow sorting, filtering, prioritization, and timely-filing guidelines, including high-dollar, all-age-group, and special accounts • Work all payer types

🎯 Requirements

• High School diploma or equivalent • 2+ years previous experience in healthcare revenue cycle management • Advanced proficiency in CPT and ICD-10 • Full-scope revenue cycle management framework knowledge • Professional-level communication skills via video, phone, and email • Ability to prioritize work to meet deadlines and expectations • Ability to meet quality and productivity measures outlined by Quadris • Critical thinking skills • Ability to remain present and focused and eliminate distractions • Self-starter • Ability to work independently and within a team atmosphere • Professional-level skills in Microsoft Excel, Word, and PowerPoint • Proficient application of business/office standard processes and technical applications • Ability to maintain compliance with regulations and laws applicable to the job • Must be able to lift 15 pounds at one time • Must be able to structure a home office to ensure patient information is secure and meet regulatory expectations

🏖️ Benefits

• Fully remote work arrangement • Home office arrangement to ensure patient information security • Opportunity to work with healthcare finance partners and contribute to technology innovation • Values-driven work environment focused on customer service, relationships, accountability, quality, and new ideas

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