Urology AR Collections Specialist
5 days ago
Calpion/Plutus Health is seeking an experienced AR Collection Specialist to join our team. This role involves working with insurance companies, payers, and internal teams to resolve unpaid claims related to Urology services. The successful candidate will have strong analytical skills, attention to detail, and excellent communication skills.
Key Responsibilities:
- Claims Follow-up: Proactively follow up with insurance companies and other payers to ensure timely resolution of unpaid claims, focusing on Urology-related services.
- Denial Management: Analyze and address claim denials, rejections, and underpayments related to Urology 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.
- Aging AR Management: Effectively manage and reduce aging accounts receivable, particularly accounts aging over 365 days, by implementing strategic follow-up and resolution techniques.
- Documentation: Maintain detailed and accurate records of all follow-up activities, payer communications, and claim statuses in the EPIC EMR system.
- Compliance: Ensure all activities comply with relevant regulations, payer guidelines, and company policies, particularly those related to Urology services.
- Collaboration: Work closely with billing, coding, and clinical teams to resolve issues and improve the overall revenue cycle process for Urology services.
- Reporting: Prepare and present regular reports on AR performance, including aging reports, denial trends, and recovery rates specific to Urology billing.
Requirements:
- Experience: Minimum of 4-5 years of experience in AR calling, with a focus on Urology billing and collections, including out-of-network collections.
- Knowledge: Strong understanding of Urology treatment services, including relevant billing codes, payer requirements, and regulatory guidelines.
- Technical Proficiency: Experience with EPIC EMR is required, along with proficiency in using billing software, electronic health records (EHR), and Microsoft Office Suite, particularly Excel.
- Skills: Excellent communication skills, both verbal and written, with the ability to interact effectively with payers, patients, and internal teams.
- 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 Urology services.
Benefits:
- $80,000 - $110,000 per year salary
- Opportunity to work with a reputable healthcare organization
- Chance to develop expertise in Urology billing and collections
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