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Billing & Insurance AR Collection Specialist with experience in Substance Use Disorder (SUD)
2 months ago
About Plutus Health Inc.:
Plutus Health Inc. is a leading provider of Revenue Cycle Management (RCM) services, dedicated to helping healthcare providers improve their financial performance. Our expertise spans across various specialties, including Substance Use Disorder (SUD) treatment. We are committed to delivering exceptional service and innovative solutions to our clients.
Job Summary:
We are seeking an experienced AR Caller with specialized knowledge in Substance Use Disorder (SUD) billing. The ideal candidate will be responsible for managing accounts receivable tasks, including following up on claims, resolving outstanding balances, and ensuring timely reimbursement. This role requires strong communication skills, attention to detail, and a deep understanding of the unique challenges associated with SUD billing.
Key Responsibilities:
- Claims Follow-up: Proactively follow up with insurance companies and other payers to ensure timely resolution of unpaid claims, with a focus on SUD-related services.
- Denial Management: Analyze and address claim denials, rejections, and underpayments related to SUD treatments, ensuring accurate resubmission or appeal processes.
- Patient Account Management: Review and manage patient accounts, including verifying insurance coverage, calculating patient responsibility, and coordinating with patients for outstanding balances.
- Documentation: Maintain detailed and accurate records of all follow-up activities, payer communications, and claim statuses in the billing system.
- Compliance: Ensure all activities comply with relevant regulations, payer guidelines, and company policies, particularly those related to SUD services.
- Collaboration: Work closely with billing, coding, and clinical teams to resolve issues and improve the overall revenue cycle process for SUD services.
- Reporting: Prepare and present regular reports on AR performance, including aging reports, denial trends, and recovery rates specific to SUD billing.
Qualifications:
- Experience: Minimum of 4-5 years of experience in AR calling, with a focus on Substance Use Disorder (SUD) billing and collections.
- Knowledge: Strong understanding of SUD treatment services, including relevant billing codes, payer requirements, and regulatory guidelines.
- Skills: Excellent communication skills, both verbal and written, with the ability to interact effectively with payers, patients, and internal teams.
- Technical Proficiency: Proficient in using billing software, electronic health records (EHR), and Microsoft Office Suite, particularly Excel.
- Attention to Detail: Meticulous in reviewing claims, identifying discrepancies, and ensuring accurate resolution.
- Problem-Solving: Strong analytical skills to investigate and resolve complex AR issues related to SUD services.
- Education: High school diploma or equivalent required; additional certification in medical billing or healthcare administration is preferred.
Why Join Plutus Health Inc.?
- Impactful Work: Contribute to a company that plays a crucial role in supporting healthcare providers, particularly in the SUD sector.
- Professional Growth: Opportunities for continuous learning, development, and career advancement.
- Supportive Environment: A collaborative team culture focused on achieving success together.
- Competitive Compensation: Attractive salary and benefits package, including health insurance, paid time off, and more.
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