Overview
This role involves managing accounts receivable (AR) functions within a healthcare setting focused on opioid use disorder treatment. The position requires adherence to local, state, and federal regulations and company policies while applying industry knowledge to resolve various types of accounts receivable.
Responsibilities
- Perform duties in compliance with applicable regulations and organizational policies.
- Resolve new and aged accounts receivables, including professional claims, governmental and non-governmental claims, denied claims, aged accounts, high priority and high dollar accounts, reimbursements, and credits.
- Utilize internal and external resources and systems to analyze patient accounting information and take appropriate payment resolution actions.
- Document all activities according to organizational and client policies.
- Communicate professionally with payer resources via websites, payer portals, email, telephone, and customer service departments.
- Maintain quality and productivity standards as measured by daily, weekly, and monthly averages.
- Review claims data and supporting documentation to identify coding and billing concerns.
- Interpret payer contracts and identify contract variances affecting reimbursement.
- Use knowledge of cash posting processes to resolve misapplied payments.
- Demonstrate proficiency in third-party billing requirements, including federal, state, and commercial/managed care payers.
- Interpret claim scrubber edits and rejections and take necessary actions to resolve issues.
- Prepare appeal letters for technical denials by accessing payer appeal forms, submitting medical documentation, and tracking appeal resolutions.
- Analyze accounts critically, considering payer contracts and billing guidelines to ensure one-touch resolution.
- Review insurance credit balances to determine root causes and resolve accounts.
- Identify denial trends, root causes, and accounts receivable impact.
- Serve as a resource to team members and assist team leads in identifying AR and denial trends.
- Perform other duties as assigned.
Requirements
- Minimum of 2 years of accounts receivable experience in a physician office setting.
- General knowledge of HCPCS, CPT-4, ICD-10 coding, and/or medical terminology.
- Familiarity with multiple payer requirements and regulations for claims processing.
- High School Diploma or GED.
Benefits
- Opportunity to have a daily impact on many lives.
- Comprehensive training provided for those new to the field.
- Mileage reimbursement at the current IRS rate, if applicable.
- Participation in community events related to addiction treatment and outreach.
- Medical, dental, and vision insurance.
- Paid time off (PTO).
- Variety of 401(k) options including a match program with no vesting period.
- Annual continuing education allowance in related fields.
- Life insurance.
- Short-term and long-term disability coverage.
- Paid maternity and paternity leave.
- Mental health day.
- Subscription to a meditation and relaxation app for all employees.
Location
Clinics are outpatient and office-based, located in Georgia, Kentucky, New Jersey, North Carolina, South Carolina, Pennsylvania, Tennessee, Texas, and Virginia.