200+ applicants

Company

Original Job Post

Ensemble Health Partners · 2 days ago

Accounts Receivable Specialist

United States

Full-time

Remote

Entry Level

1+ years exp

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Responsibilities

Examines denied and other non-paid claims to determine reason for discrepancies.

Communicates directly with payers to follow up on outstanding claims, files technical and clinical appeals, resolve payment variances, and ensures timely and accurate reimbursement.

Ability to identify with specific reason underpayments, denials, and cause of payment delay. Works with management to identify, trend, and address root causes of issues in the A/R.

Maintains a thorough understanding of federal and state regulations, as well as payer specific requirements and takes appropriate action accordingly.

Documents all activity accurately including contact names, addresses, phone numbers, and other pertinent information in the client’s host system and/or appropriate tracking system.

Demonstrates initiative and resourcefulness by making recommendations and communicating trends and issues to management.

Needs to be a strong problem solver and critical thinker to resolve accounts.

Must meet productivity and quality standards as established by Ensemble.

Qualification

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Basic computer knowledgeMicrosoft excel proficiencyCrcr certificationPayment collectionComprehend toolsQuality standardsProductivity standardsAttendance policies verbal skillsProblem solvingCritical thinkingAdaptabilityClaims ReviewRevenue CycleDDE Medicare SystemPayer WebsitesMedical TerminologyInsurance Claim Terminology

Required

1+ years of customer service experience

High School Diploma/GED Required

CRCR Required within 6 months of hire (Company Paid)

Must demonstrate basic computer knowledge and demonstrate proficiency in Microsoft Excel

Excellent Verbal skills

Problem solving skills, the ability to look at account and determine a plan of action for collection

Critical thinking skills, the ability to comprehend tools provided for securing payment, and apply them to differing accounts to result in payment

Adaptability to changing procedures and growing environment

Meet quality and productivity standards within timelines set forth in policies

Meet required attendance policies

Preferred

2 or 4-year college degree

1 or more years of relevant experience in medical collections, physician/hospital operations, AR Follow-up, denials & appeals, compliance, provider relations or professional billing preferred

Knowledge of claims review and analysis

Working knowledge of revenue cycle

Experience working the DDE Medicare system and using payer websites to investigate claim statuses

Working knowledge of medical terminology and/or insurance claim terminology