P36073 Accounts Receivable Specialist - RCM (Unfilled)

US Anesthesia Partners, Inc.•Remote,

10d•Remote

About The Position

The Accounts Receivable Specialist – RCM is responsible for collecting outstanding accounts receivable from third party payers through various projects assigned by management; both government and commercial. This role anticipates and responds to a wide variety of issues/concerns and works independently to assist in creating and maintaining documentation of key processes. At this time, US Anesthesia Partners does not hire candidates residing in California, Hawaii, or Alaska.

Requirements

High school graduate or equivalent.
Excellent verbal and written skills to maintain professionalism in all methods of communication.
Basic math skills for calculating anesthesia units, proper reimbursement, and percentages for appropriate adjustments.
General understanding of medical terminology.
Advanced knowledge of insurance processing, payer policies, guidelines, and explanation of benefits (EOB’s).
Knowledge of commercial payer, Medicare, and Medicaid guidelines.
Data entry skills with high accuracy.
General knowledge and understanding of CPT, ICD-10, and ASA codes.
Good problem-solving skills.
Decision making ability with sound judgment.
Strong analytical skills and attention to detail, including gathering and aggregating information.
Ability to work effectively with all team members, including physicians and external vendors or patients.
Must be able to work in a virtual team environment.
Ability to work independently with limited supervision.
Computer application skills to include MS Word, MS Excel, MS Outlook, and MS Teams.

Nice To Haves

Associate or bachelor’s degree in business administration or related field of study preferred.
Minimum of 3 years accounts receivable experience preferred.

Responsibilities

Performs advanced level work related to denial management.
Processes and follows up on all appeal types, at an expert level, to all payers.
Takes actionable steps to resolve open claims, as needed, including refiling or appealing claims, or resolving manual tasks assigned to AR for review.
Works outstanding accounts receivable from assigned projects.
Functions as an SME across multiple workflows and various payers.
Provides peer payer and system training support.
Identifies denial patterns and escalates to management for follow-up and/or root cause resolution.
Makes recommendations to work queues and claim edits to improve efficiency and reduce denials.
Reviews payer communications related to changes in medical and reimbursement policies.
Researches payer trends identified by offshore partners to recommend training/process improvement.
Identifies opportunities for and actively participates in process improvement initiatives.
Maintains strictest confidentiality.
Maintains basic proficiency with using spreadsheets.
Maintains productivity and quality standards established by RCM.
All other duties as assigned.