Sanctuary Recovery Centers | Accounts receivable | ...

The AR Specialist will be responsible for managing the accounts receivable including denied and underpaid claims for behavioral health services. The ideal candidate must have a strong understanding of AR processes, healthcare billing, particularly within the behavioral health setting, and be familiar with regulatory standards like HIPAA and HCPCS/CPT/ICD-10 coding. Essential Job Duties and Responsibilities í‚· Review outstanding AR to determine necessary action. í‚· Investigate and resolve denied or unpaid claims by communicating with insurance companies, patients, and internal team. í‚· Utilize payer portals to maximize reimbursement. í‚· Prepare and submit denied claims as targeted project files to payers when necessary. í‚· Identify problematic claim trends and contract violations, report findings to the RCM Manager. í‚· Submit appeals as necessary. í‚· Contact payers regarding recoupment payments, overpaid accounts, and missing checks; initiate dispute process as needed and report all findings to the RCM Manager. í‚· Review underpayments and overpayments, summarize findings and report to the RCM Manager. í‚· Update insurance information in patients accounts as necessary. í‚· Work in conjunction with other billing staff to ensure timely filing. í‚· Attend departmental meetings/conference calls. í‚· Provide feedback to management as needed. í‚· Understands and adheres to Sanctuary Recovery Centers compliance standards. í‚· Performs other duties as assigned. Qualifications: Education, Experience, and Skills Required: í‚· High school diploma or equivalent. í‚· 5+ years of medical billing experience. í‚· Strong understanding of Arizona healthcare billing, particularly behavioral health services. í‚· Strong problem-solving skills to handle denied claims efficiently. í‚· Knowledge of HCPCS, CPT, ICD-10 coding, and medical terminology. í‚· Working knowledge of Kipu EMR Software and ADS Medics Premier (preferred) í‚· Working knowledge of CMS guidelines, contracted insurance guidelines and coding policies. í‚· Advanced proficiency in Microsoft Excel and Word. í‚· Detailed oriented, reliable, and able to multi-task in a fast-paced, high-volume work environment. í‚· Ability to maintain a high level of confidentiality by adhering to the HIPAA guidelines and regulations. í‚· Must have excellent written and verbal communication. í‚· Must have a valid driver license and be 18 years of age or older. í‚· Must be able to pass a background check. í‚· Must be able to pass substance abuse testing.

Created: 2024-11-26