PBO Revenue Cycle AR Specialist II

Texas Health•Arlington, TX

19h•Onsite

About The Position

This role is responsible for expediting and maximizing payment and resolution of insurance medical claims by resolving edits, denials, and payment issues in a timely manner. The specialist will document follow-up notes, ensure high-quality account resolution using HRO tools, and identify/escalate trends impacting AR collections. The position requires exceeding productivity goals, completing special projects, and demonstrating expertise in various payors (Medicare, Medicaid, commercial) and revenue cycle operations. Adherence to HIPAA compliance and participation in educational activities are also key aspects of the role. The specialist will stay current on collection procedures, assist with training, and provide support to team members, showcasing strong technical and account resolution skills.

Requirements

High School Diploma or Equivalent required
2 Years PB AR management, denial management experience in a healthcare revenue cycle environment.
Strong working knowledge of insurance plans, billing guidelines, denial resolution processes, reconsiderations, appeals, recoupments, and reimbursement practices is required.
Revenue Cycle Government Payors (Medicare and Medicaid) life cycle of a claim knowledge.
Knowledgeable on Appeals, Reconsideration, and Recoupments.
Productivity 45 Accounts Daily.
2 or more years of experience in Denial Follow -Up and AR Work.

Nice To Haves

Associate's Degree Business or healthcare related field preferred
Experience with specialty billing and payer-specific requirements is highly preferred.

Responsibilities

Expedite and maximize payment and resolution of insurance medical claims by resolving edits, denials, payment issues in a timely manner.
Document clear, concise, and complete follow up notes in system for each account worked.
Ensure accounts are completed and worked at a high level of quality by using HRO tools and monitoring output.
Identify, analyze, and escalate trends impacting AR collections.
Exceeds established productivity goals.
Complete special projects to improve team performance, as assigned.
Demonstrate expertise of all payors, including Medicare, Medicaid and commercial payors, and applicable departments revenue cycle operations.
Ensure protection of private health and personal information. Adheres to all HIPAA compliance requirements.
Participate in educational activities and attends team meetings.
Remain current on collection and follow up procedures of various payors and specialty departments.
Assist with knowledge sharing, payor, and department training, and provide support to other team members as advised by leadership team.
Demonstrate strong technical skills and account resolution abilities.