AR Specialist - Triage & Investigations

Zotec Partners•, (Multiple States)

About The Position

At Zotec Partners, we are seeking an AR Specialist to join our AR Triage & Investigations team. In this role, you will dig into claim rejections and denials, get to the root of billing discrepancies, and work directly with insurance carriers to keep outstanding claims moving toward resolution. Zotec Partners is a company with over 25 years of experience, dedicated to partnering with physicians to simplify the business of healthcare. We are a team of over 900 employees, described as Innovators, Collaborators, and Doers, committed to transforming the healthcare industry.

Requirements

Prior experience in medical billing, accounts receivable, or healthcare claims follow-up
Working knowledge of insurance claim processes, EOBs, denial codes, and appeals procedures
Familiarity with payer portals and/or clearinghouses
Strong written and verbal communication skills for payer correspondence
Comfort working in a high-volume, deadline-driven environment
Detail-oriented with strong organizational and time-management skills
Proficiency with Microsoft Excel and Salesforce

Nice To Haves

Knowledge of CPT, ICD-10, and HCPCS coding
Prior experience in a revenue cycle management (RCM) environment

Responsibilities

Review and triage Salesforce Cases, directing them to the appropriate teams or departments within the Enterprise
Follow up on claims rejections and denials to determine cause and appropriate next action
Identify billing issues and route or correct them as needed
Communicate with insurance companies to obtain status on outstanding claims
Work daily correspondence work files, prioritizing by age and dollar impact
Process and follow up on appeals, tracking outcomes through resolution
Resolve correspondence issues, including EOB discrepancies and payer requests for additional information
Document all account activity clearly and accurately in the billing system
Escalate trends or recurring denial patterns to leadership when identified
Meet daily/weekly productivity and quality standards for case resolution