PBO Revenue Cycle AR Specialist II

Texas Health Resources•Arlington, TX

1d•Onsite

About The Position

The PBO Revenue Cycle AR Specialist II role at Texas Health is a full-time position focused on expediting and maximizing the payment and resolution of insurance medical claims. This role involves resolving edits, denials, and payment issues in a timely manner, documenting follow-up notes, and ensuring high-quality account resolution using HRO tools. The specialist will identify and escalate trends impacting AR collections, exceed productivity goals, and complete special projects to improve team performance. A key aspect of the role is demonstrating expertise with various payors, including Medicare, Medicaid, and commercial payors, and understanding revenue cycle operations. The position also requires adherence to HIPAA compliance and staying current on collection procedures. Collaboration and knowledge sharing with team members and leadership are also important components of this role.

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.