Accounts Receivable (AR) & Follow-Up Specialist

About the role

The Revenue Cycle AR and Follow-Up Specialist at Clinical Health Network for Transformation (CHN) supports the mission and promise of Planned Parenthood to enhance health equity. Reporting directly to the Revenue Cycle Manager, this role manages the accounts receivable process, ensuring timely collection of payments, resolving claim denials, and maintaining accurate financial records.

Responsibilities

• Handle complex accounts for follow-up, appeal, and credit balance resolution
• Follow up on unpaid claims to collect outstanding balances
• Investigate and resolve claim denials by reviewing medical records, coding, and payer contracts
• Write and submit escalated appeal letters and represent compelling cases to overturn denials with payors, following all billing and compliance regulatory guidelines
• Review daily clearinghouse rejections, resolve, and alert management of any trends in claim rejections
• Maintain detailed and accurate patient financial records, documenting all account notes and actions taken
• Work with healthcare providers to obtain necessary medical documentation, referrals, or authorizations required for claim processing and reimbursement
• Review aged accounts, coordinate and escalate any denial and appeal projects with payors
• Achieve established key performance indicators (KPIs) for position
• Communicate effectively with insurance companies, patients, and healthcare providers to resolve billing issues and ensure accurate claim submission
• Assist Manager to resolve issues and provide support and guidance to the revenue cycle team
• Ensure compliance with all CHN and affiliate policies, as well as all state and federal regulations

Qualifications and Experience

• Bachelor's degree in healthcare administration or equivalent experience
• Minimum of 2 years of relevant account receivable experience
• Previous experience using ICD-10 Medical Coding and Current Procedural Terminology (CPT)
• Strong analytical and problem-solving abilities
• Proficiency with Microsoft software (Excel, etc.)
• Demonstrated ability to maintain a customer-centric service approach in a fast-paced environment
• Excellent written and verbal communication skills and ability to collaborate and interact with all levels within and outside of CHN if necessary
• Strong attention to detail and follow-up; and ability to multi-task in fast-paced environment
• Demonstrated dedication to Planned Parenthood’s mission, vision, and values
• Strong interpersonal skills and the ability to build relationships with stakeholders
• Excellent time management, and problem-solving skills

Preferred Qualifications and Experience

• Strong General Technology Skills: proficient utilization of Excel, Word, and Windows environment, Epic, eCW, NextGen or other practice management systems experience a plus
• Medical Billing and Coding certification, Certified Revenue Cycle Representative (CRCR) or other certification a plus
• Willingness to travel in accordance with the needs of the position, as outlined in the essential functions

Pay and Benefits

$22 - $32 an hour
Clinical Health Network for Transformation (CHN) provides a competitive benefits package, including health care coverage (Medical, Dental, & Vision), flexible spending accounts, short-term disability and basic life & AD&D insurance, employee assistance program, retirement plan, and paid time off program. CHN is committed to building an inclusive workplace that values racial & social justice.