Accounts Receivable Specialist - Remote

Company: Ventra Health, Inc.
Location: San Diego
Posted on: June 25, 2022

Job Description:

Job Summary: - -

• Onsite training for up to 4-weeks in office.
• Accounts Receivable ("AR") Specialists are primarily responsible for analyzing collections, resolving non-payables, and handling bill inquiries for more complex issues. AR Representatives are responsible for insurance payer follow-up ensuring claims are paid according to client contracts. Complies with all applicable laws regarding billing standards. - -Essential Functions and Tasks: -
  • Follows up on claim rejections and denials to ensure appropriate reimbursement for our clients
  • Process assigned AR work lists provided by the manager in a timely manner
  • Write appeals using established guidelines to resolve claim denials with a goal of one contact resolution
  • Identified and resolved denied, non-paid, and/or non-adjudicated claims and billing issues due to coverage issues, medical record requests, and authorizations
  • Recommend accounts to be written off on Adjustment Request
  • Reports address and/or filing rule changes to the manager
  • Check system for missing payments
  • Properly notates patient accounts
  • Review each piece of correspondence to determine specific problems
  • Research patient accounts
  • Reviews accounts and to determine appropriate follow-up actions (adjustments, letters, phone insurance, etc.)
  • Processes and follows up on appeals. Files appeals on claim denials
  • Scan correspondence and index to the proper account
  • Inbound/outbound calls may be required for follow up on accounts
  • Route client calls to the appropriate RCM
  • Respond to insurance company claim inquiries
  • Communicates with insurance companies for status on outstanding claims
  • Meet established production and quality standards as set by Ventra Health
  • Performs special projects and other duties as assigned -Education and Experience Requirements: -
    • High School Diploma or GED
    • At least one (1) year in data entry field and one (1) year in medical billing and claims resolution preferred
    • AAHAM and/or HFMA certification preferred
    • Experience with offshore engagement and collaboration desiredKnowledge, Skills, and Abilities (KSAs): -
      • Intermediate level knowledge of medical billing rules, such as coordination of benefits, modifiers, Medicare, and Medicaid and understanding of EOBs
      • Become proficient in use of billing software within 4 weeks and maintain proficiency
      • Ability to read, understand, and apply state/federal laws, regulations, and policies
      • Ability to communicate with diverse personalities in a tactful, mature, and professional manner
      • Ability to remain flexible and work within a collaborative and fast paced environment
      • Basic use of computer, telephone, internet, copier, fax, and scanner
      • Basic touch 10 key skills
      • Basic Math skills - - - -
      • Understand and comply with company policies and procedures
      • Strong oral, written, and interpersonal communication skills
      • Strong time management and organizational skills
      • Strong knowledge of Outlook, Word, Excel (pivot tables), and database software skills - -IND1

Keywords: Ventra Health, Inc., San Diego , Accounts Receivable Specialist - Remote, Other , San Diego, California