Remote AR Specialist - Medical Billing

Crossroads Treatment Centers•Atlanta, GA

1d•Remote

About The Position

Crossroads Treatment Centers is seeking an AR Specialist to join their team. This role involves utilizing industry knowledge to resolve accounts receivables, including professional claims, governmental and non-governmental claims, denied claims, aged accounts, high priority accounts, high dollar accounts, reimbursements, and credits. The specialist will analyze patient accounting information, leverage internal and external resources, and document all activity. Communication with payer resources via portals, email, and phone is essential. The role requires maintaining quality and productivity standards, reviewing claims data for coding and billing issues, and interpreting payer contracts. Responsibilities also include resolving misapplied payments, understanding third-party billing requirements, interpreting claim scrubber edits, preparing appeal letters, and analyzing accounts for one-touch resolution. Additional duties may involve reviewing insurance credit balances and identifying denial trends. The specialist will also serve as a resource to other team members and assist Team Leads.

Requirements

At least 2 years accounts receivable experience in a physician office setting.
General Knowledge of HCPCS, CPT-4 and ICD-10 coding and/or medical terminology.
Familiar with multiple payer requirements and regulations for claims processing.
Must have a High School Diploma/GED.

Nice To Haves

Excellent training if you are new to this field.

Responsibilities

Performs all duties and responsibilities in accordance with local, state, and federal regulations and company policies.
Utilize and apply industry knowledge to resolve new and aged accounts receivables by working various account types, including but not limited to professional claims, governmental and/or non-governmental claims, denied claims, aged accounts, high priority accounts, high dollar accounts, reimbursements, credits, etc.
Leverage available resources and systems (both internal and external) to analyze patient accounting information and take appropriate action for payment resolutions, document all activity in accordance with organizational and client policies.
Communicate professionally (in all forms) with payer resources to include websites/payer portals, e- mail, telephone, customer service departments, etc.
Maintain quality and productivity results at a level that meets departmental standards as measured by a daily/weekly/monthly average.
Reviews claims data and supporting documentation to identify coding and/or billing concerns.
Ability to interpret payer contracts and identify contract variances affecting reimbursement.
Utilize knowledge of the cash posting processing to obtain the necessary information to resolve misapplied payments.
Demonstrate clear proficiency in third-party billing requirements to include federal, state, and commercial/managed care payers.
Interpret claim scrubber edits/rejections and takes appropriate action necessary to resolve issues.
Seek resolution to problematic accounts and payment discrepancies.
Prepare appeal letters for technical denials by accessing specific payer appeal forms, submitting appropriate medical documentation, and tracking appeal resolution.
Analyze accounts with critical thinking; consider payer contracts and billing guidelines to ensure one-touch resolution.
Reviewing insurance credit balances to determine root cause and take the steps necessary to resolve the account.
Identify denials trends, root cause, and A/R impact.
Serve as a resource to other team members and assist Team Leads with identifying A/R and denials trends.
Other Duties as Assigned.

Benefits

Medical, Dental, and Vision Insurance
PTO
Variety of 401K options including a match program with no vesture period
Annual Continuing Education Allowance (in related field)
Life Insurance
Short/Long Term Disability
Paid maternity/paternity leave
Mental Health day
Calm subscription for all employees
Mileage reimbursement (if applicable) Crossroads matches the current IRS mileage reimbursement rate.
Community events that promotes belonging and education. Includes but not limited to community cook outs, various fairs related to addiction treatment and outreach, parades, addiction awareness for schools, and holiday events.