Revenue Integrity AR Specialist

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

📋 Description

• Analyze discrepancies in payer payments across Radiology, Anesthesia, and Emergency/Hospital Medicine business units.

• Identify and eliminate false positives from the inventory.

• Address underpayments for clients following specific payer contracts.

• Detect and resolve contract discrepancies by reviewing contract language and rates.

• Collaborate with internal teams and engage directly with payers.

• Submit project appeals, ideally in bulk, concerning contract performance discrepancies.

• Prepare and file underpayment appeals according to established guidelines.

• Accurately document patient accounts within source systems.

• Process and track appeals, including managing inbound and outbound calls.

• Communicate with insurance companies regarding the status of outstanding appeals.

• Meet defined production and quality benchmarks.

• Undertake special projects and other assigned responsibilities.

⛳️ Requirements

• High School Diploma or GED.

• A minimum of three (3) years of experience in medical billing, specifically in resolving Accounts Receivable, contacting insurance carriers, utilizing payer portals, completing appeals, and identifying and conveying trends.

• Experience with offshore collaboration and engagement is preferred.

• Familiarity with State, Federal, and Managed Care regulatory guidelines.

• Understanding of benefit insurance billing and contract management.

• Proficient in Outlook, Word, Excel (including pivot tables), and database software.

• Excellent oral, written, and interpersonal communication skills.

• Strong decision-making, problem-solving, and time management abilities.

• Basic skills in word processing, spreadsheets, databases, and presentation software.

• Fundamental mathematical skills, including percentages and decimals.

• Capability to read, comprehend, and apply state and federal laws, regulations, and policies.

• Ability to exercise sound judgment and manage sensitive and confidential information appropriately.

• Capacity to remain adaptable and operate within a collaborative and fast-paced environment.

• Ability to engage with diverse personalities in a tactful, mature, and professional manner.

• Must achieve proficiency in billing software within four weeks and maintain it.

• Understand and adhere to company policies and procedures.

🏝️ Benefits

• Ventra performance-based incentive plan.

• Discretionary incentive bonus in line with company policies.

• Referral bonus for recommending a friend.

• Reasonable accommodations for qualified individuals with disabilities.