Full-Time Medical Claims AR Manager (Athena/Washington)

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.

• Management of the accounts receivable (AR) including analysis of the aged AR, looking for root cause issues; writing rules where appropriate to stop errors from occurring.
• Denial management - investigating denial sources, resolving and appealing denials which may include contacting payer representatives.
• Makes independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques.
• Collaborate internal teams (Performance, Operations, Sales) as well as care center staff when appropriate.
• Works closely with our Revenue Optimization team, to support efforts to ensure reimbursement is in line with payer contract agreements. Performs Denial analysis utilizing the Trizetto platform.
• Work directly with practice consultants or physicians to ensure optimal revenue cycle functionality
• Drive toward achievement of department’s daily and monthly Key Performance Indicators (KPIs), requiring a team focused approach to attainment of these goals.

Requirements:

• 3+ years experience in a physician medical billing office
• Experience with major payers such as Anthem, Medicare/Medicaid, United Healthcare
• Athena EHR experience required
• Behavioral Health physician billing experience preferred
• Experience supporting medical claims billing in DC/ MD/ VA preferred
• Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims
• Advanced Microsoft Excel skills

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