Accounts Receivable Specialist (remote)

Cognizant Technology Solutions-posted 9 months ago
$46,000 - $65,000/Yr
Full-time • Entry Level
Remote • Earth City, MO
Professional, Scientific, and Technical Services
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This is a remote position open to any qualified applicant in the United States. The successful candidate performs advanced level work related to resolution of physician claim denials. This position will be responsible for root cause analysis physician payer denials, experience in identifying procedures impacted by National Correct Coding Initiative Edits (NCCI), technical payer policies, appeal documentation and resolution. In addition, this position will be responsible for identification, collaboration, and implementation of process initiatives to reduce denials.

  • Follow up directly with payers to resolve claim issues and secure appropriate and timely reimbursement.
  • Identify and analyze denials and payment variances and take action to resolve account including drafting and submitting technical appeals.
  • Examine denied and underpaid claims to determine the reason for discrepancies.
  • Communicate directly with payers to follow up on outstanding claims, file technical appeals, resolve payment variances, and ensure timely reimbursement.
  • Identify specific reasons for underpayments, denials, and causes of payment delays.
  • Work with management to identify, trend, and address the root causes of issues in the A/R.
  • Maintain a thorough understanding of federal and state regulations, as well as payer-specific requirements.
  • Document activity accurately including contact names, addresses, phone numbers, and other pertinent information.
  • Demonstrate initiative and resourcefulness by making recommendations and communicating trends and issues to management.
  • Meet productivity and quality standards.
  • Possess basic knowledge of entire RCM process with 2-3 years' experience working in RCM specifically collections.
  • Recognizes problems or trends and provides suggestions to help find resolutions.
  • Strong knowledge of medical terminology, CPT codes, modifiers, and diagnosis codes.
  • Ability to follow up on outstanding AR.
  • Ability to review, interpret EOBs 835/837 and respond using medical guidelines and policies.
  • Prioritize pending claims from aging basket and follow up at regular intervals to collect outstanding.
  • Knowledge in writing appeals and following through the appeals process.
  • Resolve accounts to get paid with a maximum of 2 touches.
  • Strong analytical skills and ability to meet assigned deadlines.
  • Exceptional problem solving and critical thinking skills.
  • Demonstrates knowledge and expertise in state/federal billing guidelines, reimbursement methodologies, and payer policies.
  • Makes recommendations for additions/revisions/deletions to work queues and claim edits to improve efficiency.
  • Exceptional Excel skills to summarize and provide detailed reporting to management and client.
  • Tracks and trends claim denials and underpayments to identify initiatives for payer, process or technology improvement plans.
  • Strong communication skills both verbal and written.
  • Medical/Dental/Vision/Life Insurance
  • Paid holidays plus Paid Time Off
  • 401(k) plan and contributions
  • Long-term/Short-term Disability
  • Paid Parental Leave
  • Employee Stock Purchase Plan
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