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Methodist Health System · 3 days ago

AR Specialist 3

Dallas, TX

Full-time

Onsite

Mid Level

Methodist Health System is a faith-based organization dedicated to improving lives through quality healthcare. The AR Specialist 3 role focuses on developing and facilitating a claims training program, emphasizing appeals and denials, to secure reimbursement and minimize write-offs.

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Responsibilities

Subject matter expert with a complete understanding of professional billing. Maintains working knowledge of all departmental workflows and processes, applicable insurance carriers’ timely filing deadlines, claims submission and resubmission processes, and appeal processes

Lead the development, implementation, and continuous improvement of claims training curriculum and education initiatives. Collaborate with managers and team leads to identify workflow gaps, develop AR follow-up policies and procedures, and ensure they are accurately reflected in training manuals. Schedule and conduct comprehensive department training sessions

Create and continuously update training resources and documentation. Collaborate with team leads, claims staff, and cross-departmental team members to enhance the quality and relevance of training materials

Provide denial and payer related issue trends to leadership for escalation of data to payer relations team. Support department leadership through research, analysis, and special project assistance. Actively participate in huddle meetings and share detailed case insights

Team coaching and standards compliance providing ongoing coaching and refresher training to ensure team adherence to standards, regulations, and best practices

Train new employees and teach strategies for prioritizing cases, reviewing account history, remit, and payer history to determine the appropriate challenge and appeal strategy

Understanding knowledge of medical terminology, CPT codes, modifiers, and diagnosis codes

Complete understanding of the revenue cycle process to include prior authorization, billing, insurance appeals, and physician billing collection

Apply prior knowledge of denials to assess and ensure services/items billed are reasonable and necessary

Promote collaborative teamwork and proactively suggest procedural improvements to management to enhance departmental efficiency and effectiveness

Communicate clearly and openly

Be accountable for your performance

Take initiative for your professional growth

Be engaged and eager to build a winning team

Qualification

Claims training programInsurance industry knowledgeRevenue cycle processMedical terminologyProfessional certificationTeam coachingCommunication skillsInitiative

Required

An Associate Degree in Accounting, Finance or Business Administration or equivalent experience in the Healthcare Industry

In-depth knowledge in the insurance industry

Proven ability to train employees in a fast paced environment

Subject matter expert with a complete understanding of professional billing

Maintains working knowledge of all departmental workflows and processes, applicable insurance carriers' timely filing deadlines, claims submission and resubmission processes, and appeal processes

Lead the development, implementation, and continuous improvement of claims training curriculum and education initiatives

Collaborate with managers and team leads to identify workflow gaps, develop AR follow-up policies and procedures, and ensure they are accurately reflected in training manuals

Schedule and conduct comprehensive department training sessions

Create and continuously update training resources and documentation

Collaborate with team leads, claims staff, and cross-departmental team members to enhance the quality and relevance of training materials

Provide denial and payer related issue trends to leadership for escalation of data to payer relations team

Support department leadership through research, analysis, and special project assistance

Actively participate in huddle meetings and share detailed case insights