AR Denial Specialist

BHG Careers•Dallas, TX

11d•Hybrid

About The Position

This position will act as a key member of the Revenue Cycle Department and reports to the Director, Contract and Revenue Cycle. The Revenue Cycle Specialist will help facilitate claims, payments, and verifications daily. The Revenue Cycle Specialist will provide updates and reports on the financial stability of the treatment centers.

Requirements

Reviews claims data to ensure insurance requirements, eligibility, prior authorizations and proper signatures are secured prior to submission.
Submits claims in an organized sequence in order to achieve reimbursement from private payers, insurance companies and government healthcare programs with heavy concentration in Medicaid.
Will investigate declined claims through research and applicable correspondence in order to successfully resolve payment discrepancies.
High school Diploma or equivalent
Denial Management Skillset
Strong knowledge of Excel
High integrity
Excellent verbal and written communication skills
Sound judgment
Efficient
Self-starter
Strong interpersonal communication skills
Valid driver’s license.
Healthcare experience preferred.
Experience in front desk, admissions, billing, and/or collections.
Excellent verbal and written communication skills.
Strong customer service and interpersonal communication skills.
Accurate data entry and basic keyboarding skills.
Ability to work independently under pressure and handle multiple tasks simultaneously.
Ability to enforce fee collection policies.
Basic computer/word processing skills.
Knowledge and use of typical office equipment (calculator, fax machine, copier, computer, telephone, postage meter, scales, scanner, and computer programs).
Knowledge of basic math, accounting, and accounts receivable.

Nice To Haves

Communicate effectively by phone or in person.
Vision adequate to read correspondence and computer screens.
Prolonged sitting, some bending, stooping, and stretching.
Manual dexterity for operating office equipment.
Variable workload and periodic high stress.
Standard medical office environment.
Interaction with patients with various health and legal issues.
Extended keyboarding periods.

Responsibilities

Reviews claims data to ensure 3rd party billing requirements are met
Reviews claims to ensure eligibility, prior authorizations and proper signatures
Submits claims in an organized sequence in order to achieve reimbursement from private payers, insurance companies and government healthcare programs (Medicaid, VA, etc.)
Investigates denied claims through research and applicable correspondence and follows through to resolution
Successfully resolves payment discrepancies in a timely manner
Escalates issues appropriately and promptly to supervision
Verifies and informs treatment center staff about the patient’s financial accountability and 3rd party reimbursement, as applicable
Posts payments and adjustments while ensuring all deposits are balanced daily
Documents payment records and issues as they occur
Completes reporting requirements as required by company policy and requested by supervision
Demonstrates an understanding of NPI, taxonomy and electronic claim submission requirements
Identifies underpayments and overpayments/credits to determine steps for resolution
Retrieves missing payment information from payers through various methods (phone, payer portals, clearing houses, etc.)
Reads debits and credits on accounts and takes necessary action to resolve
Performs other duties assigned by supervision
Responsible for complying with all federal, state and local regulatory agency requirements
Responsible for complying with all accrediting agencies
Participate in community and public relations activities as assigned.
Responsible for the achievement of assigned specific annual goals and objectives
Demonstrates the belief that addiction is a brain disease, not a moral failing
Demonstrates hope, respect, and caring in all interactions with patients and fellow Team Members
Establishes and maintains positive relationships in the workplace
Can work independently and under pressure while handling multiple tasks simultaneously
Makes decisions and uses good judgment with confidential and sensitive issues
Deals appropriately with others in stressful or other undesirable situations
Participate in and provide in-service trainings as required by federal, state, local, and accrediting agencies
Attend conferences, meetings and training programs as directed
Participate in and/or schedule and attend regular in-service trainings
Demonstrated commitment to valuing diversity and contributing to an inclusive working and learning environment