If you are seeking to join one of the Connecticut top ranked Medical Group’s with the opportunity to learn, grow and become a valued member of our team, we would like to speak with you! We are currently expanding our team hiring a A/R Specialist (Denial Management)

If you are seeking a rewarding career opportunity, I invite you to apply, one of our HR/Talent Acquisition members will reach out to discuss the next steps!

• Job Title: A/R Specialist (Denial Management)
• Department: Billing/Revenue Cycle Operations
• Location: New Haven, CT
• Schedule: 8 AM - 4:30 PM
• Job Type: Full-Time + Excellent Benefits Package
• Salary: $55,000 - $65,000

Position Summary
The incumbent is responsible for maximizing the timely receipt of the maximum allowable reimbursement for the medical services provided by our licensed health care providers. Follows up on rejected and denied claims and under payments, using the Practices electronic health record and payers Explanation of Benefit forms.

Principal Duties & Responsibilities

• Work with insurance carriers, (both governmental and commercial) and outsourced Billing company to obtain payment on delinquent charges by maintaining a timely follow up process
• Preparation and submission of all necessary documentation, including reconsiderations/appeals in order to obtain maximum allowed reimbursement.
• Responsible for any corrections of edits prior to transmission of electronic claims
• Responsible for reconciliation of billing account transactions to ensure accurate information according to established guidelines/procedures
• Maintain reasonable aging of outstanding accounts receivable, for assigned accounts
• Responsible for communicating issues and inefficiencies encountered in daily processes
• Responsible for maintaining and keeping all edits, denials, and rejections at a current status within the established time frame
• Works collaboratively with all members of the Practice, including office staff, outsourced billing staff and members of the Billing Department to streamline processes and identify gaps in workflow that are impacting claims processing and payment.
• Follow-up on rejected claims assigned within task queue. Using data from the monthly aged accounts receivable report, contact payors to inquire about unpaid claims and record response or activity in the Practice EMR/PM systems.
• Resolve patient and insurance payer inquiries, relating to payments and outstanding balances, insurance coverage, and other various A/R topics while participating in the Department’s telephone and email coverage.
• Maintain current knowledge of major payor payment provisions and regulations; as well as CPT codes, ICD-10 codes, and modifier requirements
• Interact with payer portals to obtain needed data for appeal or payment status.
• Participates in a team efforts to fulfill area goals and work requirements. Deal positively with co-workers and supports management decisions
• Maintains patient confidentiality; complies with HIPAA and compliance guidelines established by the Practice
• Special projects as assigned by management

Required Experience, Education & Licensure

• Incumbent must possess a minimum education of a High School Diploma or GED. It is preferred that the candidate hold a billing certification from an accredited institution and/or have a minimum of 3 years previous work experience within a physician group accounts receivable department, in a denial management role.
• Candidate must be detailed oriented, extremely organized, able to simultaneously work on numerous efforts and demonstrate incredible persistence and determination when dealing with complicated and arduous scenarios with insurance payers. Candidate must possess professional written and verbal communication skills and be able to highly function both independently and within a team setting.

Job Type: Full-time

Pay: $55,000.00 - $65,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Education:

• Bachelor's (Preferred)

Experience:

• Accounts receivable: 1 year (Preferred)
• denials management: 1 year (Preferred)

Work Location: In person

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