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AR Specialist

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Date: Oct 7, 2018

Location: Dallas, TX, US, 75240

Company: Envision

AR Specialist

Ascension at Home is growing and looking for experienced AR Specialists to join our team.

We’re seeking candidates with:

  • Minimum 5 years AR experience
  • Medical AR experience required
  • Home Health/Hospice experience preferred, not required
  • Ability to work in a fast paced, high energy environment

Job Summary:

AR Specialist Team Member is responsible for ensuring timely reimbursement for hospital billed claims. Minimum 5 years of hospital collections experience required. Knowledge of Commercial, Third Party Insurance Accounts including but not limited to Medicaid, Managed Care, HMO, PPO, Auto and Work Comp. Rules and Guidelines governing collection activities. Working accounts in a computerized automated environment.

Essential Duties and Responsibilities:

  • Conducts appropriate account activity on final billed claims by contacting government agencies, third party payers, and patients/ guarantors via phone, email, or online.
  • Timely follow-up on all accounts assigned, work accounts as established procedures until account is resolved, sent to legal, or disputed.
  • Validate denial reasons and ensures coding is accurate and reflects denial reasons.
  • Generate an appeal based on the dispute reason and contract terms specific to the payor. This includes online reconsideration.
  • Responsible for maintaining inventory on desks with no backlog.
  • Ensures proper account documentation which is clear, concise and includes all pertinent information.
  • Daily calls to payers to obtain payment resolution and account status information
  • Consistently follows established processes and procedures for all assigned accounts and projects to ensure prompt payments and account resolutions
  • Makes appropriate and necessary corrections to patient account information as needed to ensure timely payment.
  • Follow specific payor guidelines for appeal submission.
  • Research contract terms/ interpretation and compile necessary supporting documentation for appeals.
  • Immediate and appropriate escalation of payor trends and issues to management which impact cash, aging and processes.
  • Maintains or exceeds 95% of established productivity goals and quality standards.
  • Utilizes company software in all account follow-up activities and promotes working toward paperless environment.
  • Ensures professional verbal and written communication with facilities, clients and co-worker following established guidelines. Obtains management approval when necessary to communicate with external clients about internal processes and procedures.
  • Follows and maintains patient, account and client confidentiality at all times. Adheres to HIPAA and Compliance Policy Guidelines.
  • Follows time-keeping and attendance policy daily.

Educational and Experience Requirements:

  • High school diploma or GED required
  • Require 5 years of hospital medical collections experience
  • Knowledge of Commercial, Third Party Insurance Accounts including but not limited to Medicaid, Managed Care, HMO, PPO, Auto and Work Comp. Rules and Guidelines governing collection activities.

Certificates, Licenses and Registrations:

  • Medical Billing and Coding Certificate a plus but not required.

Ascension at Home isa leading provider in the delivery of compassionate patient-centered healthcare services including home health, infusion therapy and hospice.

Formed in 2014, Ascension at Home is a national partnership between Ascension Health and Evolution Health. The partnership includes all Ascension-affiliated home health, hospice, home infusion therapy and private duty/supportive care services. Visit us at www.ahah.net to learn more about our organization and view all career opportunities.

 


Nearest Major Market: Dallas
Nearest Secondary Market: Fort Worth

Job Segment: Medical, Clinic, Hospice, Palliative, Medicaid, Healthcare

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