Medical Billing/ A/R Collections- Surgery

Full Time
Remote
Posted
Job description
Description:


Do you have 2+ years of ASC revenue cycle experience OR orthopedic billing & collections experience?

Are you looking for an incredible opportunity to work in an environment where we have more fun than we probably should?

What we Do: Full Revenue Cycle Management for Outpatient Surgical facilities. NSN is the industry leader in ASC reimbursement. We navigate complex payer policies, including and understanding payment models for both contracted and non-contracted payer types, we identify payer trends and work from front end demographic capture, coding, and billing to back-end EOB analysis, cash applications, insurance, and patient collections.


What we offer:
Nonhospital/clinic setting. Full time position with benefits. Training. Fun, upbeat, positive, energetic workplace.

Position Overview: Reporting to the Client Operations Manager, the Revenue Cycle Specialist - Collector must have a strong knowledge of medical collections, accounts receivables, insurance billing and verification, denial processing, appeal submission and EOB review. This position is responsible to resolve outstanding surgical claims resulting in maximum reimbursement.

Responsibilities:

  • Timely follow-up and resolution on all outstanding A/R including unpaid/underpaid/denied claims for all payers including self-pay to obtain maximum reimbursement.
  • Manage daily work queue to prioritize high dollar claim balances.
  • Review & work incoming insurance and patient correspondence including refund requests.
  • Send appeals when appropriate or provide the requested medical documentation.
  • Ability to review medical documentation to justify medical necessity.
  • Review patient balances to ensure accuracy and follow up with patients to obtain payments.
  • Take incoming patient phone calls to resolve inquiries, billing issues, or outstanding balances.
  • Review insurance payments and determine accuracy of reimbursement based on contracts, fee schedules or summary plan documents.
  • Leverage knowledge of Medicare, state Medicaid, and local coverage determinations (LCD’s) for claim resolution.
  • Negotiate payment amounts for procedures with Third Party Administrators for out of network providers.
  • Recommend an adjustment when applicable or recommend a refund for overpayments
Requirements:
  • 2+ years of ASC revenue cycle OR orthopedic collections experience.
  • Ability to read and interpret insurance explanations of benefits and managed care contracts.
  • Must communicate effectively, both verbally and in writing, with internal and external clients.
  • Must be able to multi-task and handle competing priorities while meeting or exceeding deadlines
  • Knowledge or experience working with a variety of health care insurance payers is preferred
  • Intermediate computer proficiency in Microsoft Office including Excel and Outlook
  • Advantx, Vision, HST, Waystar experience preferred.
  • High School Diploma or equivalent.

NOTE: This is only a Remote Position if you are not within reasonable travel distance to our Dallas, TX, Tampa, FL or Sioux Falls, SD office. ASC facility billing experience is required to work remotely.

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