Overview
A technology-driven national physician enablement organization is seeking a Senior Accounts Receivable (AR) & Case Management Specialist (Senior AR Manager) to manage and optimize the revenue cycle process for physician practices. This role involves overseeing claims processing, managing denials, resolving escalated issues, and ensuring timely reconciliation of accounts receivable items.
Responsibilities
- Manage accounts receivable including analysis of aged AR to identify root causes and implement corrective rules.
- Investigate denial sources, resolve and appeal denials, including communication with payer representatives.
- Make independent decisions regarding claim adjustments, resubmissions, appeals, and other claim resolution methods.
- Serve as an escalation point for complex issues and escalate to appropriate parties when necessary.
- Suggest and lead policy updates related to AR and claims management.
- Collaborate directly with practice consultants and physicians via Salesforce to optimize revenue cycle functionality.
- Drive achievement of daily and monthly departmental Key Performance Indicators (KPIs) through team coordination.
- Oversee functions within Accounts Receivable such as Claims Worklists, Zero Pay, Unapplied, and Denials to ensure timely review and resolution.
- Act as a subject matter expert and point of escalation within an internal sub-team.
- Perform other duties as assigned.
Requirements
- High school diploma or equivalent.
- Minimum 5 years of experience in a physician medical billing office or equivalent claims experience.
- Strong understanding of revenue cycle drivers and ability to investigate and resolve complex claims.
- Proficiency with Microsoft Excel (pivot tables, VLOOKUP, sorting/filtering, formulas) preferred.
- Experience with athenaOne suite of tools preferred.
- Experience using Salesforce for case management preferred.
- Ability to provide a private, quiet workspace with high-speed internet if working remotely.
- Experience with VA payers and providers preferred.
- Compliance with HIPAA rules and regulations.
- Excellent written and verbal communication skills.
Compensation & Benefits
- Hourly pay range: $23 to $25 per hour, exclusive of bonuses and benefits.
- Eligible for an annual bonus targeted at 10%.
- Benefits include medical, dental, vision, life, and pet insurance, 401(k), paid time off, and wellness programs.
- Base pay will be determined based on experience, education, and geographic location.
Additional Information
- All candidate information will be kept confidential in accordance with EEO guidelines.
Technical Requirements for Remote Workers
- Minimum internet speed of 5 Mbps download and 3 Mbps upload required prior to employment.
- Employees working from home offices may be eligible for expense reimbursement related to internet costs.
Location
Remote or onsite options available depending on candidate location and role requirements.