Independence Physician Management (IPM) · 3 days ago

Accounts Receivable Specialist - Remote

Wayne, PA

Full-time

Remote

Entry Level

1+ years exp

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Hospital & Health Care

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Responsibilities

Accurate and timely follow-up on claims that have not received a response, have been denied, or have been under/over paid. Works with payer to determine reasons for denials. Corrects and reprocesses claims for payment in a timely manner. Proceeds with appeals process as needed. Performs eligibility and claim status follow-up inquiries utilizing outbound calls to the payer, web link tools and payer websites. Documents all actions taken on accounts worked according to the department policy to ensure clear understanding of encounter status

Identifies root causes and denial trends and makes recommendations to department leadership to prevent additional denials. Maintains a strong working knowledge of payer requirements and can research payer policies including LCD’s and NCD’s to help determine root cause for denial trends.

As a last resort after exhausting all efforts, performs accurate write-offs (e.g. no authorization) following the identification of uncollectible accounts. Strictly adheres to IPM CBO write-off policies and procedures and utilizes proper adjustment aliases as defined in departmental job aides.

Participates in regularly scheduled team meetings sharing denial trends specific to claim requirements to enhance front end claim edits to facilitate first pass resolution. Contributes ideas for workflows and approaches to A/R follow-up tasks to maximize opportunities for performance, process, and net revenue collections improvement.

Meets established productivity metrics for the AR Department. Meets routinely with Supervisor to review productivity results and understands best practices and opportunities to create efficiencies in order to achieve maximum performance.

Meets established quality metrics for the AR Department. Meets monthly with Supervisor to review quality results and collaborate on ways to improve scores. Upon receipt of monthly QR report, corrects any errors identified.

Qualification

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Healthcare revenue cycle experienceCPT/ICD-10 coding knowledgeClaim submission requirementsReimbursement guidelinesDenial reason codesRevenue cycleService-orientedComputer literacyMicrosoft OfficeProblem-solving ability

Required

High School Graduate/GED required.

Experience (1-3 years minimum) working in healthcare revenue cycle

Healthcare (professional) billing, knowledge of CPT/ICD-10 coding, government, managed care and commercial insurances, claim submission requirements, reimbursement guidelines, and denial reason codes

Excellent organization skills, attention to detail, research, and problem-solving ability.

Results oriented with a proven track record of accomplishing tasks within a high-performing team environment.

Service-oriented/customer-centric.

Strong computer literacy skills including proficiency in Microsoft Office