Better Life Partners · 20 hours ago
RCM AR Specialist
Maine, United States
Full-time
Hybrid
Mid Level
$22/hr - $29/hr
3+ years expBetter Life Partners is dedicated to healing from addiction by providing virtual and in-person counseling and support. The RCM AR Specialist is responsible for managing the back-end billing and collections cycle, requiring expertise in medical claims and payer regulations while ensuring excellent customer service and attention to detail.
CommunitiesHealth CareMedicalWellness
Responsibilities
Review denied claims based on assigned markets, payers and work queues within our practice management system
Accurately and efficiently processes requests for denied claims information using website portals and outbound phone calls for all Commercial, Medicare and Medicaid insurance payers
Researches and responds to documentation requests from insurance carriers in a timely manner
Processes appeals of insurance denials and follows-up until the appeal is resolved
Obtains, reviews and updates patient demographics and insurance information within both EHR and practice management billing system as needed
Complete timely follow-up on claims submitted to payer, but no response or ERA after 45 days to resolve any pending issues with claim and payer within timely filing limits
Documents clear and concise activities performed in the system for each account worked
Adheres to all HIPAA (Health Insurance Accountability and Portability Act) guidelines and regulations
Ability to consistently maintain productivity and quality expectations as defined by the leadership team
Alert management to irregularities, insurance trends and areas of concern with reimbursement
Completes other tasks and projects as assigned by RCM Leadership
Qualification
Required
Bachelor's Degree or Equivalent experience
3 or more years of experience in physician group practice in a denial management role
Prior experience resolving out of network denials, and value based (bundle) claims
Proficient in CPT and ICD-10 coding terminology
Enjoy working in a fast paced and rapidly changing environment
Strong relationship building skills both external and internal
Thrive on working independently
Ability to consistently maintain productivity and quality expectations as defined by the leadership team
Adheres to all HIPAA (Health Insurance Accountability and Portability Act) guidelines and regulations
Ability to ensure any protected health or proprietary data/information is not visible (or audible) to others in any work location
Must have reliable internet service with a fast upload/download ability
Must have a quiet space to speak to members, team members, or external partners with minimal background noise and distractions
Preferred
Familiar with opioid use disorders, substance abuse use disorders and other areas of behavioral health billing
Certified Medical Coder, CPC or CCS, preferred but not required
Deep knowledge of medical insurance payers and regulations
Knowledgeable in the healthcare & mental health industries - terminology, regulations, and processes
Familiar with all aspects of the RCM Life cycle as it relates to claim reimbursement
Benefits
Competitive compensation package
Chance to be the change you wish to see in your community
Recovery-friendly workplace that values family life, diversity, equity, and inclusion
Company
Better Life Partners
Better Life Partners provides medical and behavioral healthcare services to help people recover from addiction.
51-200 employees
Funding
Current Stage
Growth StageTotal Funding
$38.25M2023-08-29Series B· $26.5M
2021-06-10Series A· $10M
2019-01-01Series Unknown
Leadership Team
Juliana Ekong
Chief Executive Officer
David de Gijsel
Chief Health Officer
Recent News
2024-11-28
2024-05-29
2023-12-24
Company data provided by crunchbase