[Hiring] Medical Billing Specialist @The Recovery Village

Role Description

The AR Specialist will be required to complete audits, compile and create claims for submission. Responds timely to address upfront and backend rejections, working each claim billed until payment is received or deemed uncollectable.

• Ability to work virtually in a remote capacity, adhering to set working schedule with periodic contact with management throughout the day via phone or via teams.
• Daily auditing of active and non-active clients to ensure proper program, authorization, diagnosis, and revenue elements have been captured.
• Communicating with department and hospital staff to address any issues related to billing and the accuracy of charge capture, insurance, authorization, and billing.
• Addressing all rejected claims, merging, editing, and ensuring proper filing is done in accordance with ARS’ billing rules.
• Ensuring all worklists assigned by management are up to date and compliant in terms of productivity and accuracy.
• Updating EMR and patient accounts when required, and opening IT tickets to address any issues that may cause delay in billing.
• Following up post submission for any third-party billing to ensure claim(s) are on file and set to pay.
• Resolving claims issues in which the payer has rejected the claim; by filing corrective claims, filing claim level appeals, providing additional information to the payer to support the claim, or advancing the claim(s) to the next level – UR appeal and/or Management.
• Documenting actions throughout the claim life cycle by entering notes within Avatar, Waystar, and BB Tech (Tool Kit).
• Identify claim rejection and denial trends, and bringing those trends to the attention of management.
• Attend AR meeting as needed and conducted by your management team.
• Apply standard improvement processes, follow-through (PDCA); Plan, Do, Check and Action.
• Maintain strict confidentiality, adhere to Part2 regulations and HIPAA guidelines.
• Follow all state regulations and adhere to all company policies and procedures.
• Other duties as assigned.

Qualifications

• Associates Degree Preferred. High School and GED required.

Requirements

• Minimum of 3 years of experience in medical business matters at an Acute Hospital Organization, Physician practice, Behavioral Health Facility, or Medical Billing Company.
• Lean Six Sigma, Kaizen or other Lean Process Management experience a preferred asset, but not required.
• CPC, CPAT, or CPAM preferred, but not required.
• This role requires the employee to utilize their own personal computer, meeting expectations of the company's software and virus security standards.
• Windows 11 w/ latest Windows update installed. (Chromebooks and Apple computers are not compatible.)
• An “up to date” antivirus software.
• ARS does offer some reimbursement for remote office equipment.

Benefits

• Health, Vision, Dental, Employer-Matched 401(k)
• STD, LTD, and Employer-Paid Term Life Policy
• Employer Matched HSA – up to $1500 a year company contribution
• Employee Wellness Program – reduce employee premiums $40/mo
• Free MDLive telehealth benefit
• Paid Time Off - Vacation /Personal /Holiday/Sick
• Employee Referral Bonus