AR Research & Resolution Representative
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Job Description
Remote AR claims representative researching medical insurance claims and denials for USACS. Maximizing collections while minimizing lost revenue and improving payer workflows.
Responsibilities:
- Research and resolve claims to maximize cash collections and minimize denials and lost revenue
- Work on individual and project denial and claim assignments
- Work outstanding insurance or contract claims and resolve claim edits and denials
- Maintain worklists and assignments at acceptable levels based on performance targets, KPI, and quality scores
- Conduct insurance or contract follow-up, including interfacing with payers and communicating with internal and external business partners by phone and web-based tools
- Escalate items promptly
- Identify opportunities to improve department workflows and cross-functional processes
- Contribute to the development and maintenance of company-wide payer matrices and updates to Standard Operating Procedures
- Actively contribute in team meetings
- Maintain knowledge of current government and carrier regulations relevant to the industry
- Model the organization's core values
- Perform and assist with other department duties as needed
Requirements:
- High school diploma or equivalent
- 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
- Experience in medical insurance, billing experience, or equivalent training or education is helpful, but not required
Benefits:
- Medical, dental, and vision insurance options
- Health savings accounts (HSA) and flexible spending accounts (FSA)
- 401(k) employee and employer contributions
- Paid time off, including vacation, sick leave, and company holidays
- Paid parental leave & family support benefits
- Short-term and long-term disability insurance
- Life and accidental death & dismemberment (AD&D) insurance
- Employee assistance programs & wellness resources
- Bonus eligibility, equity, or other incentive programs, depending on the role
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