[Hiring] Accounts Receivable Associate Specialist @Ensemble Health Partners

Role Description

The Accounts Receivable Associate Specialist is responsible for following up directly with commercial, governmental, and other payers to resolve claim payment issues, to secure appropriate and timely reimbursement and response. This includes:

• Identifying and analyzing denials, payment variances, and no response claims.
• Drafting and submitting technical and clinical appeals.
• Providing support for all denial, no response, and audit activities.

Essential Job duties include:

• Examining denied and other non-paid claims to determine the reason for discrepancies.
• Communicating directly with payers to follow up on outstanding claims.
• Filing technical and clinical appeals, resolving payment variances, and ensuring timely and accurate reimbursement.
• Identifying specific reasons for underpayments, denials, and causes of payment delay.
• Maintaining a thorough understanding of federal and state regulations, as well as payer specific requirements.
• Documenting all activity accurately in the client’s host system and/or appropriate tracking system.
• Demonstrating initiative and resourcefulness by making recommendations and communicating trends and issues to management.
• Being a strong problem solver and critical thinker to resolve accounts.

Qualifications

• Must demonstrate basic computer knowledge and proficiency in Microsoft Excel.
• Excellent verbal skills.
• Problem solving skills, with the ability to determine a plan of action for collection.
• Critical thinking skills, with the ability to comprehend tools for securing payment.
• Adaptability to changing procedures and growing environment.
• Ability to meet quality and productivity standards within timelines set forth in policies.
• Must be inquisitive and demonstrate openness to innovation, including AI.

Requirements

• This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.
• 2 or 4-year college degree preferred.
• 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.
• Working knowledge of revenue cycle.
• Experience working the DDE Medicare system and using payer websites to investigate claim statuses.
• Working knowledge of medical terminology and/or insurance claim terminology.

Benefits

• Remote role.
• Bonus incentives.
• Paid certifications.
• Tuition reimbursement.
• Comprehensive benefits.
• Career advancement.
• This position pays between $17.00 - $18.65/hr based on experience.