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Accounts Receivable Specialist - Healthcare
$46k-61k (estimate)
Full Time 1 Month Ago
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Robert S. Smith, M.D., Inc. is Hiring an Accounts Receivable Specialist - Healthcare Near Alpharetta, GA

Company Summary:

VIZIA Diagnostics is a stand-alone, surgical pathology laboratory serving clients nationwide. Our team is focused on delivering best-in-class service excellence in diagnostic patient care.

We are a subspecialty model dedicated to the practice of gastrointestinal pathology with GI subspecialty-trained and experienced pathologists and histotechnicians focused exclusively on GI specimens to ensure the highest level of quality. VIZIA is a growing company with potential advancement into other surgical pathology specialties, including a more robust genitourinary practice.

In 2023, VIZIA was formed through an acquisition from Boston Scientific Corporation. With more than 30 years of operational expertise and advancements in diagnostic services, we are proud of what we have accomplished, but we are even more excited about what we will achieve together.

Position Summary:

The Accounts Receivables Specialist will primarily be responsible for working aged accounts receivables to obtain reimbursement from government and commercial payors. The AR Specialist will follow up with payors on submitted claims, work payor denials, submit appeals on denied claims to in and out of network payors, and all other duties assigned. Wages: $24.00 per hour plus full benefits and generous PTO.

Specific Responsibilities:

  • Review of aged accounts receivables
  • Follow up with payors on outstanding claims.
  • Review payor explanation of benefits to ensure claims are adjudicated appropriately, and charges are paid accurately per the contracted fee schedules.
  • Resubmission of corrected claims when applicable.
  • Work with the payors to resolve appeals submitted on denied claims.
  • Work closely with the other teams, departments, and leadership to ensure initiatives and deadlines are met.
  • Report on denial trends to leadership.
  • Prepare daily quality and performance reports.
  • Answering patient and payor incoming calls.
  • Performs other duties as assigned.

VIZIA Diagnostics Pathology Laboratory attests to the following: For HIPAA compliance purposes, this position has been reviewed by management and meets the 'need to know' PHI access criteria of the HIPAA Security Rule. Additionally, per the HIPAA Privacy Rule, the minimum necessary PHI data elements have been identified by management and the minimum necessary PHI access has been granted to the employee/contractor for them to satisfactorily execute the role and responsibilities of this position.

Qualifications & Experience:

  • High School Graduate or General Education Degree (GED)
  • 5 years of experience in a health care environment
  • 3 years of experience in revenue cycle management with an emphasis on payor reimbursement policies. Payor appeals, and charge resolution.
  • Demonstrated knowledge of computer systems and design
  • Experience with multi-state commercial and government payors a plus.
  • Experience with Federal and State No Surprise Act regulations a major plus.
  • Experience in negotiating single case agreements with payors a plus.

Summary:

Quality System Requirements:

In all actions, demonstrates a primary commitment to patient safety and product quality by maintaining compliance with the Quality Policy and all other documented quality processes and procedures.

For those individuals that supervise others, the following statements are applicable:

  • Assures that appropriate resources (personnel, tools, etc.) are maintained to assure Quality System compliance and adherence to the VIZIA Diagnostics Quality Policy.
  • Establishes and promotes a work environment that supports the Quality Policy and Quality System.

Knowledge:

Thorough knowledge of reimbursement and follow up strategies commercial and government payers and for both In and Out of Network plans/products. Complete knowledge of the position and responsibilities. Knowledge of insurance and ability to distinguish different plan products. Applies thorough knowledge of business concepts, procedures and practices, and a complete understanding of fundamentals in the functional area and working knowledge of other related disciplines. In-depth expertise in company's core hardware and software package (i.e., working with multiple worksheets in Excel; producing advanced screen shows in PowerPoint; inserting graphics, charts, and tables in Word; creating forms).

Cognitive Skills:

Performs mostly non-routine assignments requiring basic interpretation of established procedures. Applies strong business writing, proofreading, and editing skills (i.e., independently generates correspondence with only brief content outline from supervisor) when completing work.

Job Skills:

Detail-oriented and ability to maintain a high-level of accuracy in keying operations. Answers functional questions from internal customers; viewed as a key functional resource for insurance inquiry. Performs general administrative duties and able to create letters, memos, reports, and presentations. Anticipates and coordinates assignments and organizes own schedule to meet deadlines.

Supervision Received:

Works under general supervision with general instructions given on new assignments.

Consequence of Errors:

Errors are costly and lead to ineffectiveness in our processes and normally result in high expenditures to resolve.

Time Commitment:

The role is a full-time hybrid responsibility.

Compensation:

Compensation will be market competitive, including salary and benefits.

Job Summary

JOB TYPE

Full Time

SALARY

$46k-61k (estimate)

POST DATE

05/05/2024

EXPIRATION DATE

07/04/2024

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