Overview
A healthcare technology organization specializing in physician enablement is seeking an AR & Case Management Specialist. The organization partners with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and promote high-value care delivery in both in-person and virtual settings. Their cloud-based platform is led by experienced industry and physician leadership focused on reducing unnecessary healthcare costs, improving patient outcomes, and supporting provider well-being.
Responsibilities
- Manage accounts receivable, including aged AR analysis and root cause identification
- Develop rules to prevent recurring errors
- Investigate, resolve, and appeal claim denials, including contacting payer representatives as needed
- Independently make decisions regarding claim adjustments, resubmissions, and appeals
- Serve as an escalation point for claim-related issues
- Recommend and lead policy updates when necessary
- Collaborate with practice consultants and physicians using Salesforce to optimize revenue cycle operations
- Drive achievement of daily and monthly department Key Performance Indicators (KPIs)
- Perform other duties as assigned
Requirements
- High school diploma
- Minimum of 5 years of experience in physician medical billing or equivalent claims experience
- Strong understanding of revenue cycle performance drivers and complex claim resolution
- Preferred skills: Microsoft Excel (pivot tables, VLOOKUP, formulas), athenaOne tools, Salesforce case management
- Ability to work remotely with a private workspace and high-speed internet
- 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, excluding bonuses and benefits
- 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) plan
- Paid time off
- Wellness programs
Location
- Remote position requiring a private workspace and reliable 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.