We are GROWING and adding to our TEAM!

100% in office – no remote or hybrid options.

Physicians Rehab Solution ("PRS") is a national organization seeking a qualified individual to join their expanding team in the role of Accounts Receivable and Denial Management Specialist.

In this position, you will play a crucial part in the smooth operation of the revenue cycle, with a particular emphasis on handling and resolving claim denials to enable accurate and prompt payment for medical services. This individual is a highly skilled individual, who is knowledgeable in accounts receivable and insurance denial management.

NO PHONE CALLS PLEASE.

Non-negotiables of this position:

• Must be kind, positive, professional, and self-aware.
• 100% in the office environment.
• Must be willing to share office space with teammates.
• At least 2 years of experience in accounts receivables, denials management, and/or
• medical billing.
• Familiarity with ICD-10, CPT, HCPCS codes, and healthcare compliance regulations.
• Experience in payment posting, collections, and appeals.
• Experience using EMR/EHR tools.
• Strong analytical and problem-solving skills.
• Attention to detail and accuracy.
• Ability to work both independently and collaboratively within a team.
• Basic knowledge of insurance company policies and procedures.

This is a full-time, non-exempt, benefit-eligible position.

Benefits:

• GREAT Health, Vision, and Dental plans - NO WAITING PERIOD
• Day 1 PTO accrual plan holidays - NO WAITING PERIOD
• Great work/life balance
• Employer-paid LTD & Life Insurance
• 401K & Roth

Job Duties:

• Examine denied medical claims to determine why they were denied, such as coding errors, missing information, or policy inconsistencies.
• Examine denial trends to identify reoccurring problems and opportunities for improvement.
• Work with internal teams, including medical billing and coding personnel, to resolve
• denial-related issues.
• Create and implement techniques for quickly resolving claim denials.
• Resolve denials, prepare and submit appeal letters and paperwork to insurance carriers.
• Track the status of denied claims and the status of appeals.
• Ensure that claims are correctly documented and include all necessary information for submission.
• Check the patient's demographics, medical codes, and paperwork.
• To avoid denials, address any documentation gaps and anomalies.
• Generate and analyze reports related to claim denials, appeals, and reimbursement.
• Provide insights on denial trends and suggest process improvements to reduce denials.
• Monitor and manage outstanding accounts receivable to ensure timely collections.
• Conduct regular reviews of accounts, identifying and addressing discrepancies and outstanding balances.
• Collaborate with billing and collections teams to streamline processes and optimize cash flow.
• Keep up to date on healthcare industry legislation, guidelines, and coding changes, such as ICD-10, CPT, and HCPCS codes.
• Ensure compliance with HIPAA and other privacy laws when handling patient information.
• For accurate claim submission, adhere to established policies and processes.
• Collaborate with healthcare providers, insurance company representatives, and internal stakeholders to resolve claim issues.
• Maintain clear and open lines of communication to expedite the denials resolution process.
• Provide feedback and training to staff to improve coding and billing practices.
• Utilize Electronic Health Records (EHR) systems.

Additional Qualifications/Skills:

• Effective communication skills
• Ability to identify problems and recommend solutions.
• Attention to detail with strong organization, prioritizing, and analytical skills.
• Knowledge of Microsoft Office Word, Excel, and Outlook
• Ability to learn, utilize, and maintain multiple EMR systems.
• Identify and report trends and prior authorization issues relating to insurance verification and authorizations.
• Follow written and verbal communications.
• Strong Customer service skills.
• Must have the ability to be mentored and receptive to management training processes.
• Create and maintain an environment that is consistent with the company’s values and objectives.
• Conveys a professional image and attitude.
• Ability to communicate and collaborate with a variety of teams and individuals.
• Working knowledge and ability to apply professional standards of practice in job situations.
• Ability to make independent decisions when circumstances warrant.
• Ability to self-reflect and become self-aware.

Job Type: Full-time

Pay: $21.00 - $25.00 per hour

Benefits:

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

Schedule:

• Day shift
• Monday to Friday

Application Question(s):

• What is your desired hourly rate of pay?

Ability to Relocate:

• Bowling Green, KY 42104: Relocate before starting work (Required)

Work Location: In person