• Perform weekly and monthly routine reviews of the accounts receivables, assisting the collection managers as needed.
• Works with the collection managers on developing the worklists for all the collection associates.
• Responsible for reviewing Adjustment Requests, getting the necessary approvals before accounts are written off/or adjusted. (Responsible for managing the ADJ Widget).
• Performs all functions of a collector as needed based on projects assigned by the collection managers.
• Guide and mentor other collectors and assist management with process improvement and training manuals.
• Work closely with the collection team, UR and Medical Records Department to gather the clinical documentation to conclude a proper medical review and appeal.
• Ensures that all collection events are being followed, by policy and procedure.
• Ensures collectors are meeting the production standards.
• Respond timely to payer denials, using insurance appeal policies, and company policies with respect to “formed” denial letters and workflow.
• Addresses billing errors and trends both internally and externally to maintain high level of claim submission and accuracy.
• Identify denial trends, and additional process improvement opportunities that can aid revenue cycle operations.
• Compile and complete projects based on denial trends and payers issues – as well assisting the special projects team as needed.
• Provides support to the billing department assisting when needed and providing input back to Revenue Integrity and Audits Department.
• Performs analysis of workflows, data, system details, and other technical or business issues associated with the department.
• Demonstrate knowledge and understanding of Explanation of Benefits (EOB’s) or Electronic Remittance Advice (ERA).
• Read and understand all aspects of an EOB/ERA - One should be able to define and verbalize how the following terms pertain to the payment process: billed amount; allowed amount; deductibles; coinsurances; co-payments
• Attend denial meetings, and payer meetings
• Apply standard improvement processes and follow-up through (PDCA) Plan, Do, Check and Act
• Works directly with AR Management in month-end closing and reconciliation – along with YE Audits.
• Troubleshoots payment posting and balance issues.
• Trains and leads by example for all cash posters, billers and collectors.
• Meet monthly closing deadlines Demonstrate the ability to post in all systems.
• Perform other related duties incidental to the work described herein.
• Maintain strictest confidentiality; adheres to all HIPAA guidelines and regulations.
• Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks.
• Participates in professional societies.
• Follows all state regulations for development regarding professional license
• Excellent computer skills and record keeping skills.
• Ability to work as part of a multidisciplinary team.
• Ability to communicate accurately and concisely, written and oral .
• Excellent interpersonal and telephone skills.
• Other Duties as assigned

REQUIRED EDUCATION AND EXPERIENCE:

• Associates Degree Preferred. Experience in specific job function maybe substituted for education.
• Three + years of experience in medical business matters at an Acute Level Organization, or Physician practice.
• Lean Six Sigma, Kaizen or other Lean Process Management experience a preferred asset.
• CPC, CPAT Required.
• CPAM preferred but not required. Job experience may substitute for certification.
• CRCR certification preferred

We offer great benefits including 401(k), paid time off plan, medical, dental, vision, and much more.

BENEFITS:

• Pay: Competitive salary
• Paid Time Off: Up to 3 weeks of paid time off per year
• Retirement: 401K + match
• Insurance: Health, Vision, Dental, Life Insurance. PLUS Teladoc access and visits at NO cost to the employee.
• Matching HSA -up to $1500 a year contribution from the company to your HSA.

Healthcare monthly premiums starting at:

Advanced Recovery Systems, a national integrated behavior healthcare management company dedicated to the treatment of addiction, substance abuse, eating disorders and mental health issues. We invite you to learn more about us at our website!

The Company complies with state and federal nondiscrimination laws and policies that prohibit discrimination based on age, color, disability, national origin, race, religion, or sex. It is unlawful to retaliate against individuals or groups based on the basis of their participation in a complaint of discrimination or on the basis of their opposition to discriminatory practices/EEO

We are proud to be a drug-free workplace.

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