Posted: 2 weeks ago
Posted: 2 weeks ago
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Job Description
Overview
- The Denials Specialist (Accounts Receivable (“AR”) Specialist) is primarily responsible for analyzing collections, resolving non-payables, and handling bill inquiries for more complex issues. AR Specialists are responsible for insurance payer follow-up ensuring claims are paid according to client contracts. Complies with all applicable laws regarding billing standards.
Responsibilities
- Follows up on claim rejections and denials to ensure appropriate reimbursement for our clients.
- Process assigned AR work lists provided by the manager in a timely manner.
- Write appeals using established guidelines to resolve claim denials with a goal of one contact resolution.
- Identified and resolved denied, non-paid, and/or non-adjudicated claims and billing issues due to coverage issues, medical record requests, and authorizations.
- Recommend accounts to be written off on Adjustment Request.
- Reports address and/or filing rule changes to the manager.
- Check the system for missing payments.
- Properly notates patient accounts.
- Review each piece of correspondence to determine specific problems.
- Research patient accounts.
- Reviews accounts and determines appropriate follow-up actions (adjustments, letters, phone insurance, etc.).
- Processes and follows up on appeals. Files appeals on claim denials.
- Inbound/outbound calls may be required for follow-up on accounts.
- Respond to insurance company claim inquiries.
- Communicates with insurance companies about the status of outstanding claims.
- Meet established production and quality standards as set by Ventra Health.
- Performs special projects and other duties as assigned.
Qualifications
- High School Diploma or GED.
- At least one (1) year in the data entry field and one (1) year in medical billing and claims resolution preferred.
- AAHAM and/or HFMA certification preferred.
- Experience with offshore engagement and collaboration desired.
Skills
GasOnshoreDataWelfarePoliciesPerformance ManagementRefineryResearchProductionIf a job posting appears fraudulent, asks for payment, contains misleading information, or violates our guidelines, please report it immediately. Our team will review it promptly, Jobaaj does not charge any fee from the applicants.
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