AR Research and Resolution Representative

Posted 3 Days Ago
Be an Early Applicant
OH
Entry level
Healthtech
The Role
The AR Research & Resolution Representative is responsible for maximizing cash collections, minimizing denials and lost revenue, and working on individual and project denial and claim assignments in the medical billing revenue cycle management field. The role involves researching and resolving medical claims and insurance denials, with an emphasis on claim completion and quality metrics per hour.
Summary Generated by Built In

Job Posting Closing Date: Open until Filled

Where do you belong?

Your career is more than just a job, it's part of your life. Whether you’re a clinician, or non-clinical professional, at USACS you'll feel a sense of connection working with clinicians and office staff who share your interests and values. We want you to love coming to work each day because you believe in what you do and the people with whom you work. We care about your success.

USACS also understands that location is important. We offer career opportunities for clinicians and non-clinical support staff from New York to Hawaii and numerous points in between. Our supportive culture, outstanding benefits and competitive compensation package is best in class.

Job Description

The AR Research & Resolution Representative is responsible for maximizing cash collections, minimizing denials and lost revenue, modeling the organization's values, and working on individual and project denial and claim assignments.

Location: Remote

This position is part of medical billing revenue cycle management. The role is heavily focused on researching and resolving medical claims and insurance denials.

This position has an emphasis on claim completion, productivity and quality metrics per hour.

ESSENTIAL JOB FUNCTIONS:

  • Performs various complex duties, including, but not limited to, working outstanding insurance or contract claims and resolving claim edits and denials. Maintains worklists and assignments at acceptable levels based on performance targets, KPI, and quality scores. 
  • Conducts all insurance or contract follow-up aspects, including interfacing with payers, communicating with internal and external business partners by conducting phone calls, and utilizing web-based tools. Escalates items promptly.
  • Identifies opportunities to improve department workflows and cross-functional processes. Contributes to the development and maintenance of company-wide payer matrices and updates to Standard Operating Procedures
  • Serves as an active contributor in team meetings.
  • Maintains knowledge of current government and carrier regulations relevant to the industry.
  • Models the core values of the organization.
  • Performs and assists with other department duties as needed.

KNOWLEDGE, SKILLS AND ABILITIES:

  • Knowledge of and skill in using personal computers in a Windows environment, emphasizing basic word processing and data entry onto spreadsheet programs.
  • Knowledge of medical insurance and its terminology.
  • Basic knowledge of ICD-10 and CPT codes.
  • Ability to work independently and as an effective team contributor.
  • Ability to pay close attention to detail.
  • Ability to identify, research, and solve problems and discrepancies.
  • Ability to communicate courteously and professionally.
  • Ability to maintain confidentiality.
  • Ability to process assigned duties in an organized manner.
  • Ability to perform basic mathematical calculations such as adding, subtracting, multiplying, and dividing.
  • Ability to effectively perform in a multi-task work environment.
  • Ability to work overtime when needed.
  • Ability to work effectively in remote settings.

EDUCATION AND EXPERIENCE:

  • High school diploma or equivalent. 
  • At least one year of medical insurance, billing experience, or equivalent training or education.

PHYSICAL DEMANDS:

  • While performing the duties of this job, the employee is regularly required to sit for prolonged periods and occasionally walk, stand, bend, stoop, and lift up to 15 pounds. 
  • Required to have close visual acuity to perform the job.

Hourly Rate: $14.50 - $22.00

Hourly rate may be determined on several factors including but not limited to knowledge, skills, experience, education, geographical location and requirements stated in job description.

US Acute Care Solutions current and potential employees enjoy best in class benefit programs with a wide array of options. To learn more, please visit the following link: https://www.usacs.com/benefits-guide-2024

Click the red apply button to submit an application and resume. If you are an USACS employee, please apply via the Jobs Hub in the Workday system.

The Company
HQ: Canton, OH
9,276 Employees
On-site Workplace
Year Founded: 2015

What We Do

Founded by emergency medicine physician groups in Colorado, Florida, Maryland, Ohio and Texas, USACS is the national leader in physician-owned integrated acute care, including emergency medicine, hospitalist, critical care and observation services. USACS provides high-quality care to approximately 7 million patients annually at more than 300 programs and is aligned with leading hospital systems across the country. Visit usacs.com to learn more.

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