Home Office - Revenue Cycle - A/R Specialist

Job Summary Our Accounts Receivable Specialists are extremely important members of Active Day family! They know that their work is crucial to the success of our business and is key to our success. Our Accounts Receivable Specialists love working in a fast-paced environment that is collaborative and team-oriented. They are self-motivated, extremely detail oriented, proactive and excel at problem solving. Because our Accounts Receivable Specialists communicate with medical insurers and resolve payment denials and disputes they know how important it is to be courteous and professional in all forms communications. Building strong relationships internally and externally is crucial to this team’s success.   Qualifications High school diploma or equivalent; Bachelors or Associate’s Degree in an Accounting field and/or minimum 1 year prior experience in Revenue Cycle role strongly preferred. Prior working knowledge and experience with medical EHR/billing systems strongly preferred. Strong Excel skills required (ability to sort, filter, pivot, and organize large sets of data) Strong MS Word, and Outlook skills. Extremely strong analytical and mathematical skills. Knowledge of CPT-4/HCPC, ICD-10-CMJ, Revenue Codes and DRGs required. Knowledge of UB-04 and HCFA 1500 bill forms DRGs strongly preferred. Familiar with third party billing practices, contracts and regulations including but not limited to Managed Care Organizations and government payers strongly preferred. Must have very strong problem-solving skills as well as a strong attention to detail. Strong written, verbal communication and relationship building skills. Able to multi-task, meet tight deadlines while managing time effectively. Ability to work on electronic payer portals to perform applicable job duties.   Job Responsibilities Resolve collections by examining and validating submitted claims, rebilling and correcting denied claims on the provider portals to make sure that payer issues reimbursement for service(s) provided. Resolve billing discrepancies; follow up on outstanding claims by reviewing, investigating andreprocessing denied claims. Collaborates with the agency and management on identifying payer issues and trends affectingthe outstanding accounts receivable. Become the go to expert on assigned payers, including knowledge of state Medicaid regulations, such as timely filing, contacts, contracted rates and develop contacts to help resolve issues. Submit appeals for denied claims as appropriate. Correct system billing transactions when applicable claim resolution requires it. Verify validity of account discrepancies by obtaining and investigating information from various sources. Prepare reports and include status of collection efforts. Accomplish accounting and organization mission by completing related results as needed and always look for ways to assist and improve. Update receivables by accurately totaling unpaid invoices. Other duties and responsibilities as changed or assigned at any time.  #INDADS01