Responsible for accounts receivable follow-up, appeals, payer communications, denial resolution, payment posting review, self-pay follow-up, patient assistance program (PAP) support, insurance verification, and claims processing to ensure timely reimbursement and accurate billing.
Collaborate with payers, patients, and corporate teams to complete billing and reimbursement tasks accurately and on time.
Reports to: RCM Billing & Collections Manager
Daily responsibilities include:
- AR follow-up, appeals, and payer follow-up calls
- PAP follow-up
- Escalating billing, collection, posting, PAP, and self-pay issues to corporate
- Posting review and escalation support
- Franchise payments to corporate
- Billing holds management
- Remit reviews
- Routing claims to the next responsible party
- PBM claims in VS Delivery Ticket WQ
- Billing nurse visits and tracking nursing visit notes
- Responding to patient billing questions
- Incoming and outgoing phone calls and faxes
- Verification of benefits twice weekly
- Audits and medical records review
- Collect Plus patient collections in stage 2
Weekly responsibilities include:
- Confirming accuracy of checkwrite
- Ensuring Waystar rejections are worked in a timely manner
- Updating inquiry spreadsheets
- Updating franchise needs spreadsheets
Monthly responsibilities include:
- Adjustment reviews
- Cost refunds
- Denial report review
- One-on-one meetings with direct report
Requirements & Qualifications
- Medical experience: 3 years required
- Medical records experience: 1 year required
- Day shift availability required
- Ability to complete assigned training, competencies, and certificates on time
- Ability to participate in meetings as needed
- Ability to handle contracting issues and other leadership-assigned tasks
Location
Utah, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
3 weeks ago