Accounts Receivable Specialist
O.N.E Purpose
Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.
The Opportunity
- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Comprehensive Benefits
- Career Advancement
Essential Job Duties
- Examines denied and other non-paid claims to determine the reason for discrepancies.
- Communicates directly with payers to follow up on outstanding claims, files technical and clinical appeals, resolves payment variances, and ensures timely and accurate reimbursement.
- Able to identify specific reasons for underpayments, denials, and cause of payment delay.
- Works with management to identify, trend, and address root causes of issues in the A/R.
- Maintains a thorough understanding of federal and state regulations, as well as payer specific requirements and takes appropriate action accordingly.
- Documents all activity accurately including contact names, addresses, phone numbers, and other pertinent information in the client’s host system and/or appropriate tracking system.
- Demonstrates initiative and resourcefulness by making recommendations and communicating trends and issues to management.
- Needs to be a strong problem solver and critical thinker to resolve accounts.
Expected Knowledge, Skills and Abilities
- Must demonstrate basic computer knowledge and demonstrate proficiency in Microsoft Excel.
- Excellent Verbal skills.
- Problem solving skills, the ability to look at accounts and determine a plan of action for collection.
- Critical thinking skills, the ability to comprehend tools provided for securing payment, and apply them to differing accounts to result in payment.
- Adaptability to changing procedures and growing environment.
- Meet quality and productivity standards within timelines set forth in policies.
- Meet required attendance policies.
- Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.
Preferred Knowledge, Skills, and Abilities
- 2 or 4-year college degree.
- 1 or more years of relevant experience in medical collections, physician/hospital operations, AR Follow-up, denials & appeals, compliance, provider relations or professional billing preferred.
- Knowledge of claims review and analysis.
- Experience working the DDE Medicare system and using payer websites to investigate claim statuses.
- Working knowledge of medical terminology and/or insurance claim terminology.
Join An Award-winning Company
- Five-time winner of “Best in KLAS” 2020-2022, 2024-2025 Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024
- 22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024
- Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024
- Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023
- Energage Top Workplaces USA 2022-2024
- Fortune Media Best Workplaces in Healthcare 2024
- Monster Top Workplace for Remote Work 2024
- Great Place to Work certified 2023-2024
Innovation
We provide reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law.
Employment Disclaimers
Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.