RCM AR Specialist

Job Description: • Review denied claims based on assigned markets, payers and work queues within our practice management system • Accurately and efficiently processes requests for denied claims information using website portals and outbound phone calls for all Commercial, Medicare and Medicaid insurance payers • Researches and responds to documentation requests from insurance carriers in a timely manner • Processes appeals of insurance denials and follows-up until the appeal is resolved • Obtains, reviews and updates patient demographics and insurance information within both EHR and practice management billing system as needed • Complete timely follow-up on claims submitted to payer, but no response or ERA after 45 days to resolve any pending issues with claim and payer within timely filing limits • Documents clear and concise activities performed in the system for each account worked • Adheres to all HIPAA (Health Insurance Accountability and Portability Act) guidelines and regulations • Ability to consistently maintain productivity and quality expectations as defined by the leadership team • Alert management to irregularities, insurance trends and areas of concern with reimbursement • Completes other tasks and projects as assigned by RCM Leadership Requirements: • Bachelor's Degree or Equivalent experience • 3 or more years of experience in physician group practice in a denial management role • Prior experience resolving out of network denials, and value based (bundle) claims • Proficient in CPT and ICD-10 coding terminology • Enjoy working in a fast paced and rapidly changing environment • Strong relationship building skills both external and internal • Thrive on working independently Benefits: • We’re a recovery-friendly workplace that values family life, diversity, equity, and inclusion. Apply tot his job Apply To this Job