Responsibilities
- Ability to work virtually in a remote capacity, adhering to set working schedule with periodic contact with management throughout the day via phone or via teams.
- Daily auditing of active and non-active clients to ensure proper program, authorization, diagnosis, and revenue elements have been captured.
- Communicating with department and hospital staff to address any issues related to billing and the accuracy of charge capture, insurance, authorization and billing.
- Addressing all rejected claims, merging, editing and ensuring proper filing is done in accordance with ARS’ billing rules.
- Ensuring all worklists assigned by management are up to date and compliant in terms of productivity and accuracy.
- Updating EMR and patient accounts when required, and opening IT tickets to address any issues that may cause delay in billing.
- Following up post submission for any third-party billing to ensure claim(s) are on file and set to pay.
- Resolving claims issues in which the payer has rejected the claim; by filing corrective claims, filing claim level appeals, providing additional information to the payer to support the claim, or advancing the claim(s) to the next level – UR appeal and/or Management.
- Documenting actions throughout the claim life cycle by entering notes within Avatar, Waystar, and BB Tech (Tool Kit).
- Identify claim rejection and denial trends, and bringing those trends to the attention of management.
- Attend AR meeting as needed and conducted by your management team.
- Apply standard improvement processes, follow-through (PDCA); Plan, Do, Check and Action.
- Maintain strict confidentiality, adhere to Part2 regulations and HIPAA guidelines.
- Follow all state regulations and adhere to all company policies and procedures.
- Other duties as assigned.
Requirements
- High School and GED required
- Minimum of 3 years of experience in medical business matters at an Acute Hospital Organization, Physician practice, Behavioral Health Facility, or Medical Billing Company
- This role requires the employee to utilize their own personal computer, meeting expectations of the company's software and virus security standards. Windows 11 w/ latest Windows update installed. (Chromebooks and Apple computers are not compatible.) an “up to date” antivirus software.
- This is a remote position that requires regular participation in virtual meetings and video conferences. Team members are expected to have a stable internet connection, a distraction-free environment, and a functional webcam. As a representative of our organization, you are also expected to present yourself professionally during all video interactions—this includes dressing in appropriate, work-ready attire.
Nice to Have
- Associates Degree Preferred
- Lean Six Sigma, Kaizen or other Lean Process Management experience a preferred asset, but not required
- CPC, CPAT, or CPAM preferred, but not required
Benefits
- Health, Vision, Dental
- Employer-Matched 401(k)
- STD, LTD, and Employer-Paid Term Life Policy
- Employer Matched HSA – up to $1500 a year company contribution
- Employee Wellness Program – reduce employee premiums $40/mo
- Free MDLive telehealth benefit
- Paid Time Off - Vacation /Personal /Holiday/Sick
- Employee Referral Bonus
Additional Information
- Hours: 8:00am to 5:00pm ET
- Must reside in the Eastern (ET) or Central Time (CT) Zone
- ARS does offer some reimbursement for remote office equipment.
