Overview
A technology-driven national physician enablement organization is seeking an Accounts Receivable (AR) Manager to oversee the accurate and timely processing of assigned medical claims. This role involves managing claim denials, following up on aged claims, and collaborating with internal teams and physician practices to resolve claim issues.
Responsibilities
- Manage accounts receivable including analysis of aged AR to identify root causes and suggest billing rules or edits to prevent errors
- Investigate, resolve, and appeal insurance claim denials, including contacting payer representatives
- Make independent decisions regarding claim adjustments, resubmissions, appeals, and other resolution techniques
- Collaborate with internal teams such as Performance, Operations, Sales, and care center staff
- Support large care center go-lives, which may require overnight travel
- Work closely with the Revenue Optimization team to ensure reimbursements align with payer contract agreements
- Perform denial analysis using the Trizetto platform
- Work directly with practice consultants or physicians to optimize revenue cycle functionality
- Drive achievement of daily and monthly departmental Key Performance Indicators (KPIs)
- Perform other duties as assigned
Requirements
- High school diploma or equivalent
- Minimum 3 years of experience in a medical billing office or equivalent claims experience
- Strong understanding of revenue cycle performance drivers and ability to investigate and resolve complex claims
- Experience with athenaHealth and/or athenaOne required
- Orthopedic medical claims billing experience required
- Advanced Microsoft Excel skills preferred (e.g., pivot tables, VLOOKUP, sorting/filtering, formulas)
- Experience with California payers and portals preferred
- Must comply with HIPAA rules and regulations
Compensation & Benefits
- Hourly pay range: $24.00 to $26.45 (base pay only, excluding 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 applicant information will be kept confidential in accordance with EEO guidelines
Technical Requirements (for remote workers only)
- 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
- This role may require overnight travel to support care center go-lives
Applicants should be prepared to comply with all technical and operational requirements to support patients and providers effectively.