RCM AR Specialist

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

📋 Description

• Conducts follow-ups on denied claims and those with no response within a timely manner.

• Submits appeals regarding variances in contract rates when there is a discrepancy in allowed amounts.

• Provides Medical Records as requested by the payer to facilitate claims processing determinations.

• Monitors and reviews payer correspondence received through the lockbox and faxes.

• Oversees, reviews, and responds to Hub (field) communication inquiries within the required 48-hour timeframe.

• Contacts payers or checks claims status online to investigate unpaid insurance claims.

• Maintains comprehensive knowledge of practice management and other relevant computer software as it pertains to job responsibilities.

• Addresses written and telephone inquiries from insurance companies.

• Develops and sustains relationships with personnel from assigned carriers.

• Regularly meets with the Pod Lead/Supervisor to discuss and resolve reimbursement and insurance follow-up issues.

⛳️ Requirements

• High school diploma or GED equivalent is required.

• Prior experience in Medical Billing and Collections is preferred.

• Preference will be given to candidates with at least eighteen months of experience.

• Must be comfortable using email and engaging with Internet applications.

• Familiarity with practice management and Microsoft processing software is essential.

• Demonstrated understanding of Explanation of Benefits forms, claim forms, and the insurance billing process.

• Working knowledge of managed care, commercial insurance, Medicare, and Medicaid reimbursement practices.

• Basic understanding of CPT and ICD-10 coding is required.

• Strong written and verbal communication skills are necessary.

🏝️ Benefits

• Continuing education courses are available upon request.

• Opportunities to participate in educational programs to stay updated with changes in the Healthcare industry.

• Adheres to Allergy Partners and respective hub/department policies.