Job Summary: The Senior Accounts Receivable Specialist is a key component in the Revenue Cycle Management (RCM) process for Gordian Medical. Reporting directly to Revenue Cycle Management, job functions include responsibility for accurate review of accounts receivable balances, to ensure clean claims are paid timely and at the companies’ negotiated rates. Through this with the RCM and other departments, the goal involves ensuring the collected rate for service is received and the collection goals can be met. The Accounts Receivable Specialist will support the Company and its subsidiaries by providing support to staff and management while exemplifying the company culture and operating with a high level of integrity. Primary Responsibilities: · Work in accordance with the companies’ standards, practices, and policies. · Work with and direct activities with outsourced accounts receivable management sources · RCM Interdepartmental Liaison for questions · Identify payer payment trends · Assist staff with questions about claim submission or resolution · Payor mail distribution · Contact payers for claim updates via phone or various payer portals. · Work Accounts Receivable claims · Update patient files accurately and effectively with all collection activity · Generate reporting for management as needed · Work with Cash, Audit and Appeals teams · Identify managed care contractual issues and provide feedback to payer relations · Verification of hospice or home health coverage of patients, including communication to the field staff regarding this status as well as communicating with hospice companies · Collaborate across departments and build effective relationships with internal and external customers to meet deadlines and organizational goals · Exhibit high level quality level of attention to detail and monitoring of work · Daily email communication with other departments and management · Submit & meet daily performance metrics · Provide excellent customer service for both incoming and outgoing inquires · Maintain sensitivity to organizational workflow systems outside your immediate department. Understand the impact and implications of decisions and requests affecting other divisions, team and/or individuals within the company · Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance Additional Responsibilities: · Communicate regularly with the RCM Management Staff · Attend meetings as required · Attend continuing education courses when available · Peer training · Recognize denial trends · Continuously work towards the Company’s goal and vision · Other duties as directed by Manager · Submit weekly summary reports Education and Technical Skills: · High School Diploma · Keyboarding/typing skills 50 wpm · Knowledge of ICD10 codes · Knowledge of HCPC codes Additional Eligibility Qualifications/Competencies: · 1-2 years of experience in a medical/billing environment · Experienced with Durable Medical Equipment/Wound Care · Must have previous experience in insurance verification, benefits, pre-authorization, medical billing and collections · Knowledge of health care system, including but not limited to Medicare, Commercial and Medi-cal/Medicaid coverages · Strong knowledge of copay, coinsurance and deductibles · Basic knowledge in medical terminology · Detail oriented, a strong communicator, organized and able to multi-task in a fast-paced environment · Ability to work independently as well as cohesively with other team members · Knowledge in Office products such as Outlook E-mail, Word and Excel · Brightree experience · Excellent organizational skills, ability to problem solve and work as an independent worker · Good math, computer and keyboarding/typing skills · Compliance with HIPAA and PHI guidelines · This position requires excellent verbal and written communication skills · Self-motivated, proactive and takes initiative · Ability to establish and maintain relationships · Works well in team environment and independently · Able to apply critical thinking skills · Ethics - Treats people with respect; keeps commitments; inspires the trust of others; works with integrity and principles; upholds organizational values · Integrity - Behaves in an honest, fair, and ethical manner; shows consistency in words and actions; fosters a high standard of ethics and instills mutual trust and confidence; serves as a role model for others and performs actions that demonstrates their values · HIPAA – Responsible for understanding and abiding by HIPAA policies and procedures Physical Requirements: This position requires periods of time in which sitting, standing, use of hand and foot motion, vision, hearing, summarizing, focusing with frequent interruptions along with other physical, sensory and cognitive sensory functions are required. Note: The above is intended to describe the general content of and requirements for the performance of this job. It is not construed as an exhaustive statement of duties, responsibilities or requirements and may change at any time. All qualified applicants will receive consideration for employment without regard to race, ethnicity, color, religion, sex, gender identity, sexual orientation, national origin, disability, or protected veteran status. RestorixHealth is an EO employer – M/F/Veteran/Disability