RCM Accounts Receivable III

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

📋 Description

• Follow up on pending claims and appeals.

• Manage escalation views.

• Review Vendor Clarification logs.

• Deliver training for employees and vendors.

• Serve as a knowledge resource for team members.

• Handle Claim Ack Rejections, Claim Edits, and Charge Corrections.

• Contact patients regarding payments or payment arrangements.

• Print and refile claims as necessary.

• Process correspondence on a daily basis.

• Engage in ongoing education and career development training within the industry.

• Meet or surpass productivity benchmarks.

• Respond to incoming calls from patients, insurance companies, and physician offices.

• Investigate and audit patient accounts for additional payments or adjustments.

• Manage KAM reports as assigned.

• Achieve proficiency in the accounts receivable collector queue within 30 to 60 days of employment.

• Handle 40 to 50 accounts daily with a minimum of 90% accuracy, meeting departmental productivity standards.

• Calculate billing units and reimbursement figures.

• Uphold confidentiality and adhere to company policies, code of conduct, ethics statements, and corporate mandates.

• Complete all required training programs.

• Report any suspected or confirmed violations of compliance policies and other prohibited activities.

• Seek policy clarification and utilize Compliance, Human Resources, or Legal resources as needed.

⛳️ Requirements

• High School diploma or equivalent.

• 3 to 5 years of experience in a healthcare insurance receivables setting.

• 2 to 3 years of collection experience is required.

• An Associate or Bachelor’s degree in business administration or a related field is preferred.

• Preferred: 2 years of posting, coding, or accounts receivable collection experience in a healthcare organization.

• Proficient knowledge of CPT, ICD-9, and ASA codes.

• Strong mathematical, research, analytical, decision-making, and problem-solving skills.

• Excellent data gathering and reporting abilities.

• Knowledgeable in medical terminology, insurance processing guidelines, and relevant laws.

• Advanced understanding of commercial, Medicare, and Medicaid payers.

• Familiar with TWCC guidelines and laws, commercial managed care insurance, and Medicare/Medicaid guidelines.

• Strong interpersonal, verbal, and written communication skills.

• Ability to work independently with minimal supervision.

• Advanced understanding of claim requirements and capability to accurately perform billing tasks, including evaluation and correction of billing edits, claim transmission, rejections, and other claim functions.

• Proficient in Microsoft Office Suite, including Word and Excel.

• Ability to maintain strict confidentiality and comply with company policies and procedures.

🏝️ Benefits

• Paid Time Off.

• 9 observed holidays.

• Paid family leave.

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Life insurance.

• Disability insurance.

• Healthcare FSA.

• Dependent Care FSA.

• Limited Healthcare FSA.

• Transportation and parking FSAs.

• Health Savings Accounts (HSAs).

• Matching 401(k) plan.

• Opportunities for professional training and career development.

• Employee benefits, recognition, and opportunities for professional growth.