AR Specialist – Medical Billing

This is a fully remote position, open to applicants in New York, +2 more states.

📋 Description

• Executes all responsibilities in compliance with local, state, and federal laws as well as company policies.

• Apply industry expertise to address both new and aged accounts receivables by managing diverse account types, including but not limited to professional claims, governmental and non-governmental claims, denied claims, aged accounts, high priority accounts, high dollar accounts, reimbursements, and credits.

• Utilize available resources and systems (both internal and external) to assess patient accounting data and take appropriate actions for payment resolutions, documenting all activities in line with organizational and client policies.

• Engage in professional communication (across all formats) with payer resources, including websites/payer portals, email, telephone, and customer service departments.

• Maintain quality and productivity metrics at a level that meets departmental standards, as evaluated through daily, weekly, and monthly averages.

• Review claims data and related documentation to pinpoint coding and/or billing issues.

• Demonstrate the ability to interpret payer contracts and recognize contract variances that impact reimbursement.

• Apply knowledge of cash posting processes to gather required information for resolving misapplied payments.

• Exhibit a strong understanding of third-party billing requirements for federal, state, and commercial/managed care payers.

• Analyze claim scrubber edits/rejections and take necessary actions to rectify issues.

• Pursue resolutions for problematic accounts and payment discrepancies.

• Draft appeal letters for technical denials by utilizing specific payer appeal forms, submitting relevant medical documentation, and monitoring appeal outcomes.

• Analyze accounts using critical thinking; consider payer contracts and billing guidelines to ensure one-touch resolution.

• Additional responsibilities may include reviewing insurance credit balances to identify root causes and taking necessary steps to resolve accounts.

• Identify denial trends, root causes, and accounts receivable impacts.

• Act as a resource for other team members and assist Team Leads in recognizing accounts receivable and denial trends.

• Other Duties as Assigned

⛳️ Requirements

• A minimum of 2 years of accounts receivable experience in a physician office environment is required.

• General knowledge of HCPCS, CPT-4, and ICD-10 coding and/or medical terminology is essential.

• Familiarity with multiple payer requirements and regulations related to claims processing is necessary.

• A High School Diploma or GED is required.

🏝️ Benefits

• Make a daily impact on numerous lives.

• Comprehensive training for newcomers to the field.

• Mileage reimbursement (if applicable) at the current IRS mileage reimbursement rate provided by Crossroads.

• Participate in community events that foster belonging and education.

• Events include community cookouts, various fairs focused on addiction treatment and outreach, parades, addiction awareness initiatives for schools, and holiday celebrations.

• Opportunity to save lives every day!

• Comprehensive benefits package.

• Medical, Dental, and Vision Insurance offered.

• Paid Time Off (PTO).

• A variety of 401K options, including a matching program with no vesting period.

• Annual Continuing Education Allowance (in a related field).

• Life Insurance coverage.

• Short/Long Term Disability benefits.

• Paid maternity/paternity leave.

• Mental Health day off.

• Calm subscription available for all employees.