Revenue Cycle A/R Specialist

4 weeks ago

Peachtree Corners, United States JTS Health Partners Full time
Job DescriptionJob Description

Revenue Cycle AR Specialist (Hospital)

The Revenue Cycle AR Specialist will analyze and review aged accounts to final resolution.

Candidate will work collaboratively with internal team members and contribute to a positive working environment and team spirit.  A dedicated remote office space must be available with high-speed internet and peripheral equipment. 

Required Qualifications: 

  • Minimum of 5 years' experience in revenue cycle processes:

  • Within a hospital setting (UB04 format).

  • Proficient to Expert level insurance follow up, denials management, credit balance resolution.

  • Proficient to expert level knowledge of Cerner Community Works, CPSI, and/or MedHost.

  • Demonstrate experience with reviewing outstanding balances to resolution (Medicare, Medicaid, and Commercial payors).

  • Exceptional time management and organizational skills.

  • Ability to direct work with minimal supervision and ability to meet performance and quality goals.

  • High school diploma or GED required.

  • Execute and fulfill JTS’ Remote Staff Agreement to ensure Security and Privacy.   

Primary Responsibilities:   

  • Works within payer portals, such as Availity, Optum, MMIS and Medicare Contractors 

  • Understands payor contracts and can apply calculations to resolve under/overpayments.

  • Knowledge of medical terminology such as CPT, HCPCS, APC, ASC, DRG and ICD10. 

  • Understands and ability to apply EOB.

  • Submits reconsiderations and appeals related to denials using payor documentation and portals. 

  • Interacts with third party payors and patients to resolve account balances. 

  • Ability to submit corrected claims billing.

  • Reviews, research, and resolves claim rejections to resolution.

  • Uses standard work processes in daily work activities to ensure performance goals. 

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