AR Collections Specialist – Mental Health and Addiction Focused

This is a fully remote position, open to applicants in Florida.

📋 Description

• Conduct audits, compile claims, and prepare claims for submission.

• Address front-end and back-end rejections, managing each claim until payment is secured or deemed uncollectable.

• Perform daily audits on both active and inactive clients to ensure correct program, authorization, diagnosis, and revenue elements.

• Liaise with department and hospital personnel concerning billing, charge capture, insurance, authorization, and billing accuracy.

• Resolve rejected claims by merging, editing, and filing in accordance with billing regulations.

• Keep management-assigned worklists updated and compliant with productivity and accuracy standards.

• Update EMR and patient accounts, and initiate IT tickets for issues that delay billing.

• Follow up post-submission to confirm that third-party claims are recorded and ready for payment.

• Address payer-rejected claims through corrective submissions, claim-level appeals, additional supporting information, or escalation to UR appeal or management.

• Record claim lifecycle actions in Avatar, Waystar, and BB Tech (Tool Kit).

• Identify trends in claim rejection and denial, reporting these to management.

• Attend AR meetings as required.

• Implement PDCA improvement processes.

• Maintain confidentiality and comply with Part 2, HIPAA, state regulations, and company policies.

• Perform additional duties as assigned.

⛳️ Requirements

• Must reside in the Eastern (ET) or Central Time (CT) Zone.

• High School diploma or GED is required.

• Associate's Degree is preferred.

• A minimum of 3 years of experience in medical business operations within an acute hospital organization, physician practice, behavioral health facility, or medical billing company is necessary.

• Experience with Lean Six Sigma, Kaizen, or other Lean Process Management is preferred but not mandatory.

• CPC, CPAT, or CPAM certifications are preferred but not required.

• Must utilize a personal computer that meets company software and virus security standards.

• Windows 11 with the latest updates installed; Chromebooks and Apple computers are not compatible.

• Up-to-date antivirus software is required.

• A stable internet connection, distraction-free environment, and functional webcam are essential.

• Regular engagement in virtual meetings and video conferences is expected.

• Knowledge of state and federal patient confidentiality laws, drug-free workplace policies, workplace violence protocols, and corporate integrity and compliance programs is crucial.

• Understanding of customer service, personal service, mathematics, education and training, clerical tasks, computing, and reporting is necessary.

• Strong active listening, speaking, coordination, social awareness, critical thinking, judgment and decision-making, monitoring, and reading comprehension skills are required.

• Proficiency in both deductive and inductive reasoning, as well as written and oral expression and comprehension, is essential.

• Ability to work collaboratively within a multidisciplinary team.

• Clear and concise written and oral communication skills are necessary.

• Excellent interpersonal and telephone communication skills are expected.

• Capability to provide efficient financial assistance in charge, billing capture, and collection processes.

🏝️ Benefits

• Health, Vision, Dental insurance, and Employer-Matched 401(k).

• Short-Term Disability (STD), Long-Term Disability (LTD), and Employer-Paid Term Life Insurance.

• Employer Matched HSA – up to $1500 annual company contribution.

• Employee Wellness Program – reduces employee premiums by $40/month.

• Complimentary MDLive telehealth services.

• Paid Time Off for Vacation, Personal, Holidays, and Sick Leave.

• Employee Referral Bonus.

• ARS provides some reimbursement for remote office equipment.

• Remote work arrangement available.