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AR Facility Follow-up and Appeals Specialist (Fairlawn, OH)
Location:
Akron, OH
Description:
GBS RevCycle is a comprehensive Revenue Cycle Management (RCM) solution that manages the entire revenue process. Candidates with Surgery, Physical Therapy, Occupational Therapy, and/or Commercial Insurance experience strongly desired. We offer FT Benefits including a HYBRID work-schedule potential (Medical, Dental, Vision, Accident, Disability Insurance, PTO, Holiday, Wellness plans, Profit Sharing, 401 K etc.) Up to $1000 Sign on Bonus Employee's Location can be Ohio, Pennsylvania, Georgia, Florida, Texas, South Carolina, or Massachusetts POSITION SUMMARY The AR Follow-up and Appeals Rep. is responsible for following up on claims and billed professional fee charges. This person should be able to navigate payer and clearinghouse websites and utilize excellent phone skills when obtaining claim status. The goal is to perform one touch resolution by obtaining all appropriate information, commenting thoroughly and taking appropriate action for adjudication. It is imperative for this position to understand the unique requirements of each individual payer as well as the time limits surrounding claim and appeal submission. It is essential that this person fully comprehends explanation of benefits from each carrier from several different states as well as being able to identify trends and escalating in a timely manner in order to be managed efficiently. ESSENTIAL DUTIES AND RESPONSIBILITIES Effectively work from daily AR report Perform follow-up either on website or placing phone calls to Insurance Carrier or patient with unpaid claims Navigate effectively and efficiently through insurance websites Verify insurance eligibility and benefits; obtain LCD's/Carrier Policies Understand managed care authorizations and limits to coverage such as the number of visits This is encountered often when billing for specialties; know where to find such authorizations and have claim reprocessed Research credit balances providing feedback and/or prepares refunds for approval by Supervisor Process correspondence requests; respond to customer inquiries in a timely manner Provide weekly review of rejected claims and find resolutions Identify and awareness of claim submission/deadlines and escalate trends; discuss ideas for process improvement with the Supervisor Report all insurance company trends to the AR Team Lead that might be hindering payment/adjudication Maintain production standard of 40-50 accounts/day Contribute to special projects, as assigned by the AR Team Lead Performs other duties as assigned and/or assume additional responsibilities as required QUALIFICATIONS (K nowledge, Skills, and Ability Requirements) High School Graduate or equivalent Minimum of 2 years relevant experience in a health care organization Knowledgeable on insurance and reimbursement process Knowledge of medical terminology Excellent communication skills Demonstrate time management skills; must be able to meet deadlines Must be computer literate and have basic word processing, excel, and calculator skills; computation, typing and filing Must be able to work flexible hours when needed and occasional extended hours when necessary Effectively cope with change Orchestrate multiple activities at once to accomplish a goal; uses resources effectively and efficiently; detail oriented Widely trusted; keeps information confidential; maintain confidentiality within a HIPAA secure environment ENVIRONMENTAL/WORKING CONDITIONS Normal office environment Sit for long periods of time; manual dexterity, use a calculator and to operate a computer keyboard; frequent mobility required to access files; bending, stooping, walking and lifting required Must be able to work flexible hours when necessary with occasional extended hours when necessary Mandatory overtime at month-end GBS RevCycle is an equal opportunity and affirmative action employer. We consider all qualified applicants for employment without regard to race, color, religion, creed, national origin, sex, pregnancy, age, sexual orientation, transgender status, gender identity, disability, alienage or citizenship status, marital status or partnership status, genetic information, veteran status or any other characteristic protected under applicable law.
Company:
GBS Convergent Solutions
Posted:
December 26 2023 on ApplicantPro
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More About this Listing: AR Facility Follow-up and Appeals Specialist (Fairlawn, OH)
AR Facility Follow-up and Appeals Specialist (Fairlawn, OH) is a Accounting & Finance Accounts Receivable Job at GBS Convergent Solutions located in Akron OH. Find other listings like AR Facility Follow-up and Appeals Specialist (Fairlawn, OH) by searching Oodle for Accounting & Finance Accounts Receivable Jobs.
AR Facility Follow-up and Appeals Specialist (Fairlawn, OH) is a Accounting & Finance Accounts Receivable Job at GBS Convergent Solutions located in Akron OH. Find other listings like AR Facility Follow-up and Appeals Specialist (Fairlawn, OH) by searching Oodle for Accounting & Finance Accounts Receivable Jobs.