Full-Time AR Manager (Medical Claims)

AR Manager (Medical Claims Billing Specialist)

Under the direction of the Director or Manager of Revenue Cycle Management, the Accounts Receivable (AR) Manager is responsible for complete, accurate, and timely processing of all designated claims.

Primary Job Duties:

• Management of accounts receivable (AR), including analysis of aged AR and looking for root cause issues.
• Writing rules to stop errors from occurring.
• Denial management: investigating denial sources, resolving and appealing denials (contacting payer representatives).
• Making independent decisions regarding claim adjustments, resubmission, appeals, and claim resolution.
• Collaborating with internal teams (Performance, Operations, Sales) and care center staff.
• Supporting large care center go-lives, which may include overnight travel.
• Working closely with the Revenue Optimization team to ensure reimbursement aligns with payer contracts.
• Performing denial analysis using the Trizetto platform.
• Working directly with practice consultants/physicians to ensure optimal revenue cycle functionality.
• Driving achievement of department KPIs (team focused approach).
• Other duties as assigned.

Requirements:

• High School Graduate
• 3+ years experience in physician medical billing office
• Experience with major payers (Anthem, Medicare/Medicaid, United Healthcare)
• Athena EHR experience
• Behavioral Health physician billing experience (preferred)
• Experience supporting medical claims billing in DC/MD/VA (preferred)
• Understanding of revenue cycle optimal performance drivers
• Ability to investigate and resolve complex claims
• Advanced Microsoft Excel skills
• Compliance with HIPAA rules and regulations
• Interpersonal Skills:
• Comfortable speaking in front of groups
• Excellent written and verbal communication
• Willingness to train and mentor other team members
• Great time management skills
• Ability to work independently and multi-task in a fast-paced environment

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