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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

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