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Healthcare Accounts Receivable and Denial Management Specialist
3 months ago
Position Title:
Healthcare Accounts Receivable and Denial Management Specialist (Remote/Contractor)
Location:
Remote (Supporting a solo practitioner surgeon operating both in and out of hospital settings)
Job Description:
A solo practitioner surgeon specializing in both office-based and hospital-based surgeries is seeking an experienced Healthcare Accounts Receivable and Denial Management Specialist for a temporary remote contract role. The ideal candidate will have a proven track record in managing medical billing, accounts receivable (AR), and denial management within the medical surgical field. The role involves ensuring accurate and timely billing, following up on outstanding claims, and resolving denials to optimize revenue cycle management.
Key Responsibilities:
- Manage all aspects of accounts receivable, including monitoring aging reports and ensuring timely collections.
- Analyze and resolve claim denials and rejections, ensuring compliance with payer guidelines.
- Work closely with insurance companies, patients, and internal billing teams to expedite payment resolution.
- Conduct follow-up on unpaid claims and pursue appeals for denied claims as necessary.
- Utilize EHR and billing software to accurately track and record transactions and status updates.
- Provide regular reports on AR status and denial trends to ensure the practice's financial health.
- Collaborate with office and hospital billing departments to ensure smooth workflow and transition between outpatient and inpatient billing.
- Ensure adherence to coding standards and regulations (ICD-10, CPT, etc.).
Qualifications:
- Strong experience in medical billing, accounts receivable, and denial management, preferably in a surgical setting.
- In-depth knowledge of payer policies, claim adjudication processes, and appeals procedures.
- Proficiency with EHR/EMR and billing software systems.
- Excellent communication and negotiation skills for dealing with insurance payers and patients.
- Ability to work independently and manage tasks remotely.
Preferred Certifications:
Applicants are strongly preferred to hold one or more of the following certifications:
- Certified Professional Coder (CPC)
- Certified Coding Specialist (CCS)
- Certified Outpatient Coder (COC)
- Certified Professional Biller (CPB)
- Certified Inpatient Coder (CIC)
- Registered Health Information Technician (RHIT)
- Registered Health Information Administrator (RHIA)
- Certified Risk Adjustment Coder (CRC)
- Certified Orthopedic Surgery Coder (COSC)
- Certified General Surgery Coder (CGSC)
- Certified Coding Specialist - Physician Based (CCS-P)
- Certified Evaluation and Management Coder (CEMC)
- Certified Professional Coder - Apprentice (CPC-A)
- Certified Professional Medical Auditor (CPMA)
Preferred Experience:
- Experience with surgical billing in both outpatient office settings and hospital environments.
- Previous experience managing AR and denial management for surgical specialties, such as general surgery, orthopedics, or other related fields.
Contract Type:
Temporary (3-6 months with possible extension based on performance and need)
Work Environment:
This is a remote, contract position that allows for flexibility. The specialist will work closely with the solo practitioner and their billing team.
