Collections Representative, RCM or AR Calling

About the Role

• Work to improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need.
• Find a culture guided by inclusion, talented peers, comprehensive benefits, and career development opportunities.

Key Responsibilities

• Review outstanding insurance balances to identify and resolve issues preventing finalization of claim payment.
• Coordinate with payers, patients, and clients when appropriate.
• Analyze and trend data, recommending solutions to improve first pass denial rates and reduce age of overall AR.
• Ensure all workflow items are completed within the set turn-around-time within quality expectations.
• Analyze EOBs and denials at a claim level, identifying trends impacting dollar and numbers to drive process improvements.
• Perform other duties as assigned.
• Comply with all applicable Company policies, procedures, and business directives.

Requirements & Tech Stack

• Graduate
• 12+ months and above experience in healthcare accounts receivable (Denial Management)
• Accounts Receivable Specialist with an understanding of the whole accounting cycle / claim life cycle.
• Functional knowledge of HIPAA rules and regulations and experience related to privacy laws, access, and release of information.
• In-depth working knowledge of the various applications associated with the workflows.
• Solid knowledge of medical insurance (HMO, PPO, Medicare, Medicaid, Private Payers).
• Solid knowledge and use of the American English language skills with neutral accent.
• Proficient in MS Office software, particularly Excel and Outlook.

Qualifications

• Proven ability to communicate effectively with all internal and external clients.
• Proven ability to use good judgment and critical thinking skills; ability to identify and resolve problems.
• Proven efficient and accurate keyboard/typing skills.
• Demonstrated solid work ethic and a high level of professionalism with a commitment to client/patient satisfaction.