AR Specialist 2 - Hybrid Position

Methodist Health System is a faith-based organization with a mission to improve and save lives through compassionate, quality healthcare. With nearly a century of service, Dallas-based Methodist Health System is a trusted choice for health and wellness, featuring a network of 12 hospitals and over two dozen clinics. The system offers nationally recognized medical services, including a Level I Trauma Center, multi-organ transplantation, Level III Neonatal Intensive Care, neurosurgery, robotic surgical programs, oncology, gastroenterology, and orthopedics. Methodist is also known for its renowned teaching programs, innovative research, and strong community commitment.

Methodist Health System has earned numerous distinctions as an award-winning employer, including Great Place to Work Certification, recognition as one of Glassdoor’s Best Places to Work, TIME’s Best Companies for Future Leaders, Newsweek’s America’s Most Admired Workplaces, and Fortune’s Best Workplaces in Health Care.

About the role

We are seeking an experienced Accounts Receivable II (AR II) Specialist specializing in Professional Billing to join our team at our Central Business Office (CBO) location. The ideal candidate will possess a strong background in A/R follow-up for family and multi-specialty claims, with the ability to identify, address, and resolve no-response claims, denied claims, and correspondence. As an AR II Specialist, you will play a crucial role in optimizing revenue flow by effectively managing outstanding accounts receivable and ensuring timely reimbursement.

Responsibilities

• Analyze and review outstanding claims, focusing on those with no response or denials. Identify and rectify errors, discrepancies, and missing information to resubmit claims promptly and accurately.
• Investigate and address claim denials promptly. Utilize knowledge of payer policies, medical coding guidelines, and billing regulations to appeal denials and secure rightful reimbursement.
• Manage all incoming correspondence related to accounts receivable, including explanation of benefits (EOBs), remittance advice (RA), and other payer communications. Take necessary actions based on correspondence received, such as claim corrections, appeals, or adjustments.
• Conduct thorough follow-up on aging accounts receivable, prioritizing those with no response or denied claims. Utilize various communication channels to contact payers, patients, and other relevant parties to resolve outstanding balances and secure payment.
• Stay up-to-date with changes in healthcare regulations, coding guidelines, and billing requirements. Ensure compliance with HIPAA, CMS, and other regulatory standards governing healthcare billing and reimbursement.
• Collaborate closely with internal departments, including providers, coders, and billing staff, to resolve complex billing issues and streamline revenue cycle processes. Communicate effectively with external stakeholders, such as payers and patients, to facilitate resolution of outstanding accounts receivable.
• Be accountable for your performance, always looking for ways to improve the patient experience, taking initiative for your professional growth, and being engaged and eager to build a winning team.

Requirements

• High School Diploma required; college degree preferred.
• Two to four years of experience in healthcare revenue cycle management.
• Proficiency in medical billing software EPIC and electronic health record (EHR) systems.
• Strong knowledge of healthcare billing processes, medical terminology, CPT, ICD-10 coding, and billing regulations.
• Excellent analytical skills with the ability to identify patterns, trends, and discrepancies in claims.
• Effective communication and interpersonal skills, with the ability to interact professionally with internal and external stakeholders.
• Detail-oriented with a focus on accuracy and thoroughness in claim analysis, documentation, and reporting.
• Ability to prioritize tasks, meet deadlines, and work efficiently in a fast-paced environment.
• Certification in medical coding (e.g., CPC) or revenue cycle management (e.g., CRCR) is a plus.

Schedule

• Hours of work: 40 per week
• Days of week: Monday through Friday
• Position requires a 6-month probationary period to be successfully completed before being approved to work from home. WFH schedule is based on business needs.