Remote Revenue Cycle Specialist- A/R

2 weeks ago

Memphis, United States NSN Revenue Resources Full time

Job Type

Full-time

Description

We are seeking an experienced and detail-oriented Accounts Receivable Specialist to join our central billing office team for ambulatory surgery centers. The successful candidate will play a crucial role in resolving outstanding surgical claims resulting in maximum reimbursement.

Responsibilities:

  • Timely follow-up and resolution on all outstanding A/R including unpaid/underpaid/denied claims for all payers including self-pay to obtain maximum reimbursement.
  • Prioritize high dollar claim balances through work queues
  • Review & work incoming insurance and patient correspondence including refund requests.
  • Send appeals when appropriate or provide the requested medical documentation.
  • Ability to review medical documentation to justify medical necessity.
  • Review patient balances to ensure accuracy and follow up with patients to obtain payments.
  • Take incoming patient phone calls to resolve inquiries, billing issues, or outstanding balances.
  • Review insurance payments and determine accuracy of reimbursement based on contracts, fee schedules or summary plan documents.
  • Leverage knowledge of Medicare, state Medicaid, and local coverage determinations (LCD's) for claim resolution.
  • Negotiate payment amounts for procedures with Third Party Administrators for out of network providers.
  • Recommend an adjustment when applicable or recommend a refund for overpayments to insurance carriers or patients, providing the appropriate documentation.
Requirements
  • 2+ years of ASC revenue cycle OR orthopedic collections experience is preferred.
  • Strong understanding of medical billing and insurance reimbursement processes, including experience with denials and appeals.
  • Ability to read and interpret insurance explanations of benefits and managed care contracts.
  • Excellent interpersonal and communication skills.
  • Must be able to multi-task and handle competing priorities while meeting or exceeding deadlines.
  • Intermediate computer proficiency in Microsoft Office including Excel and Outlook.
  • Advantx, Vision, HST, SIS Complete, or Waystar experience preferred.
  • High School Diploma or equivalent is required.

Note: ASC facility billing experience is required to work remotely.

Salary Description

$18-$21

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