AR & Case Management Specialist

Overview

A technology-driven, national physician enablement organization is seeking an AR & Case Management Specialist. The organization partners with medical groups, health plans, and health systems to improve physician practices and patient experiences through a cloud-based platform. The platform aims to reduce healthcare costs, enhance outcomes, and support provider well-being.

Responsibilities

• Manage accounts receivable, including analysis of aged AR and identification of root causes
• Investigate, resolve, and appeal claim denials, including contacting payer representatives
• Make independent decisions on claim adjustments, resubmissions, and appeals
• Serve as an escalation point within internal teams and escalate issues appropriately
• Suggest and lead policy updates as needed
• Collaborate with practice consultants and physicians via Salesforce to ensure optimal revenue cycle operations
• Drive achievement of department daily and monthly KPIs with a team-focused approach
• Perform other duties as assigned

Requirements

• High school graduate
• Minimum 5 years of experience in physician medical billing or equivalent claims experience
• Understanding of revenue cycle performance drivers and ability to resolve complex claims
• Preferred skills in Microsoft Excel (pivot tables, VLOOKUP, formulas)
• Preferred experience with athenaOne tools
• Ability to provide a private workspace with high-speed internet for remote work
• Preferred experience with VA payers and providers
• Compliance with HIPAA regulations
• Excellent written and verbal communication skills

Compensation & Benefits

• Hourly base pay range: $23 to $25
• Eligible for an annual bonus targeted at 10%
• Base pay determined by experience, education, and location
• Benefits include medical, dental, vision, life, and pet insurance, 401(k), paid time off, and wellness programs

Location

• Remote work with requirement to provide a private workspace and high-speed internet

Equal Opportunity

The employer is an equal opportunity organization committed to diversity and inclusion. All qualified applicants will receive consideration without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.