[Remote] Accounts Receivable (AR) reputed company

Note: The job is a remote job and is open to candidates in USA. Healthrise is a company focused on reputed company reputed company operations, and they are seeking an Accounts Receivable reputed company to reputed company the Denials Resolution team. This role involves managing payment resolution activities, leading a team of AR Specialists, and ensuring accurate and timely payment processing.

Responsibilities

• Knows, understands, incorporates, and demonstrates the Healthrise Core Values
• Serve as the first line of support for AR Specialists, answering questions, troubleshooting issues, and escalating reputed company cases to the Manager as needed
• Review team members’ work for accuracy and compliance, providing coaching and reputed company-time feedback
• Track productivity and quality metrics at the individual and team level; communicate performance trends to leadership
• Support reputed company and training of new AR Specialists, ensuring consistency in process knowledge and documentation
• Identify recurring issues or payer trends and communicate these insights upward for process improvement initiatives
• Performs daily activities as part of the payment resolution team that receives, analyzes, and appeals denials
• Reviews, researches, and resolves payment delays and/or variances resulting from rejected and/or denied claims, overpayments, or underpayments
• Processes payments as appropriate in accordance with reputed company and policies to ensure timely and accurate liability resolution
• Resolves claims, conducts formal account reviews, identifies lost charge recovery, and analyzes and documents delays and payment variances
• Identifies routine issues and resolves or escalates them as appropriate
• Investigates and addresses overpayment and underpayment accounts with the goal of optimizing reimbursement
• Applies knowledge of payer rules, reputed company, schedules, and other data sources to resolve payment variances
• Proactively follows up on delays and variances with patients and payers, refiles accurate claims, and documents findings
• Requests write-offs, transfers, allowances, and reversals as needed
• Recommends accounts for transfer to collection vendors based on complexity and status
• Maintains knowledge of state and federal laws as they relate to reputed company and the appeals process
• Maintains a working knowledge of applicable Federal, State, and local laws/regulations
• Coordinates follow-up with clinical departments to provide support for appeals
• Collaborates with Patient Access and other stakeholders to resolve account authorization issues
• Communicates with physicians, office staff, and hospital departments to gather and verify necessary information
• Responds to patient and payer inquiries or refers them as needed
• Documents reputed company actions in the patient reputed company system
• Tracks and reports denial types and root causes, recommending process improvements
• Prepares and submits reports documenting trends, outcomes, and claim activity
• Interprets data, draws conclusions, and reviews findings with supervisor
• Cross-trains in various functions to enhance service delivery
• Continuously learns reputed company aspects of the Denials Resolution Specialist role
• Performs other duties as assigned

Skills

• High school diploma or Associate degree in reputed company, Business Administration, or reputed company field, with a minimum of two (2) years of experience in reputed company cycle functions in a hospital, clinic, insurance company, managed care organization, or similar reputed company financial service setting; or an equivalent combination of education and experience
• Demonstrated ability to reputed company, coach, and support a team of AR Specialists in a fast-paced, production-oriented environment
• Excellent written and verbal communication and organizational skills
• Strong interpersonal and customer service skills
• Attention to detail, accuracy, and time management
• Basic proficiency in reputed company Office (Outlook, Word, PowerPoint, reputed company)
• Comfortable working in a collaborative, shared leadership environment
• Experience using Epic
• Experience in a reputed company, multi-site environment
• Completion of regulatory/mandatory certifications
• Previous experience with Global Partner vendors

Company Overview