Accounts Receivable and Denial Management Specialist
Posted 7 days ago
You'll complete your application on RCM Staff LLC's career site.
About the Role
An accounts receivable and denial management specialist is needed to support a Florida-based physician group of multiple specialties. You will work remotely from the Philippines, contributing to the financial health of medical practices in the United States. As part of a healthcare staffing firm, you will operate within established payer portals, clearinghouses, and electronic health record systems while adhering to strict HIPAA standards and industry expertise in the U.S. revenue cycle.
Requirements
- Minimum of two years of career experience in U.S. healthcare denial management and accounts receivable follow-up.
- Ability to audit medical claims for accuracy and rectify errors concerning demographics, eligibility, or payer mistakes.
- Expertise in working with government healthcare programs like Medicare, various commercial insurance plans, and insurance-related web portals.
- Strong command of verbal and written English, coupled with high attention to detail and self-directed work capabilities.
- Maintenance of a stable home office setup with reliable internet access.
- Availability to work during U.S. Eastern Time business hours.
- Experience with AdvancedMD, Availity, First Coast SPOT, or UnitedHealthcare portals is considered an asset.
- Background in supporting hospitalist, internal medicine, pain management, or wound care practices is preferred.
Responsibilities
- Evaluate unbilled and pending claim queues to guarantee precision before filing.
- Validate insurance coverage and patient eligibility status.
- Update coding or demographic information as needed.
- Execute follow-ups on delinquent or unpaid claims by utilizing payer websites or telephonic communication.
- Investigate the reasons behind denials and prepare the necessary reconsiderations, appeals, or revised claims.
- Record all follow-up actions and monitor patterns regarding denials.
- Communicate payer-related complications to leadership.
- Meet established daily productivity goals in collaboration with the internal team of the practice.
- Ensure full compliance with HIPAA regulations during all operations to safeguard patient data.
Benefits & Perks
- This is a full-time, remote role that necessitates your availability throughout Eastern Time business hours.
Note: This listing is summarized and paraphrased by WorkNow from a publicly posted role. For the original wording and full details, please refer to the employer's official posting.
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