Accounts Receivable (AR) & Follow-Up Specialist

Clinical Health Network For Transformation (CHN); United States; On-site; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare organization is seeking a Revenue Cycle AR and Follow-Up Specialist to manage accounts receivable processes. This role involves ensuring timely payment collections, resolving claim denials, and maintaining financial records while adhering to billing regulations. The ideal candidate will have a strong commitment to health equity and possess excellent communication and analytical skills. Join a mission-driven team that values diversity and inclusion in the workplace.

Benefits

Health Coverage

Flexible Spending Accounts

Disability Insurance

Life Insurance

Employee Assistance Program

Retirement Plan with Employer Match

Paid Time Off

Qualifications

• Minimum of 2 years of relevant accounts receivable experience.
• Willingness to travel as needed.

Responsibilities

• Manage accounts receivable process ensuring timely collection of payments.
• Resolve claim denials and maintain accurate financial records.
• Communicate effectively with insurance companies, patients, and healthcare providers.

Skills

Analytical Skills

Problem Solving

Communication

Customer Service

Attention to Detail

Education

Bachelor's degree in healthcare administration

Tools

ICD-10 Medical Coding

CPT

Microsoft Excel

Job description

The vision of Clinical Health Network for Transformation (CHN) is to better fulfill the mission and promise of Planned Parenthood to bring high-quality, affordable care to every member of our communities. CHN is a collaboration between Planned Parenthood affiliates across the United States.

CHN is looking for individuals who are committed to supporting our shared goal of strengthening and enhancing our awareness and commitment to advancing the cause of health and race equity in our organization.

Reporting directly to the Revenue Cycle Manager, the Revenue Cycle AR and Follow-Up Specialist is responsible for managing the accounts receivable process within the revenue cycle. This role involves ensuring the timely collection of payments, resolving claim denials, and maintaining accurate financial records. The specialist will work closely with insurance companies, patients, and internal departments to optimize revenue collection and ensure compliance with billing regulations.

Essential Functions

1. Perform all duties of a Billing Specialist.
2. Handle complex accounts for follow-up, appeal, and credit balance resolution.
3. Follow up on unpaid claims to collect outstanding balances. Investigate and resolve claim denials by reviewing medical records, coding, and payer contracts.
4. Write and submit escalated appeal letters and represent a compelling case to overturn denials with payors, following all billing and regulatory guidelines.
5. Review daily clearinghouse rejections, resolve issues, and alert management of any trends in claim rejections.
6. Maintain detailed and accurate patient financial records, documenting all account notes and actions taken.
7. Work with healthcare providers to obtain necessary medical documentation, referrals, or authorizations required for claim processing and reimbursement.
8. Follow-up on multiple payor types across multiple states, including Commercial, Medicare, Medicaid, Medicaid Managed Care, Blue Cross, Title X, etc.
9. Review aged accounts, coordinate, and escalate denial and appeal projects with payors.
10. Achieve established KPIs for the position.
11. Communicate effectively with insurance companies, patients, and healthcare providers to resolve billing issues and ensure accurate claim submission.
12. Assist the Manager in resolving issues and providing support and guidance to the revenue cycle team.
13. Ensure compliance with all CHN and affiliate policies, as well as all state and federal regulations.
14. Demonstrate a commitment to CHN and Planned Parenthood’s mission related to health equity, especially centering racial equity, and a deep sense of accountability to the community.
15. Commit to learning about and enhancing practices related to racial equity and the impact of structural racism on healthcare systems.
16. Provide positive and developmental feedback and accountability related to practices including, but not limited to, equity.

The above duties and responsibilities are not an exhaustive list of required responsibilities, duties, and skills. Other duties may be added, and this job description can be amended at any time.

Qualifications and Experience (Required)

1. Bachelor's degree in healthcare administration or equivalent experience.
2. Minimum of 2 years of relevant accounts receivable experience.
3. Previous experience using ICD-10 Medical Coding and CPT.
4. Knowledge of medical terminology.
5. Strong analytical and problem-solving abilities.
6. Proficiency with Microsoft software (Excel, etc.).
7. Ability to maintain a customer-centric service approach in a fast-paced environment.
8. Excellent written and verbal communication skills and ability to collaborate and interact with all levels within and outside of CHN if necessary.
9. Strong attention to detail and follow-up; ability to multi-task in a fast-paced environment.
10. Dedication to Planned Parenthood’s mission, vision, and values.
11. Strong interpersonal skills and ability to build relationships with stakeholders.
12. Excellent time management and problem-solving skills.

Qualifications and Experience (Preferred)

1. Strong general technology skills: proficient utilization of Excel, Word, and Windows environment, Epic, eCW, NextGen or other practice management systems experience a plus.
2. Medical Billing and Coding certification, Certified Revenue Cycle Representative (CRCR) or other certification a plus.
3. Willingness to travel as needed, in accordance with the position’s requirements, complying with all travel policies and safety guidelines.

Key Requirements

1. Commitment to advancing race (+) equity in one’s work, with a focus on understanding racial inequity’s role in society.
2. Awareness of multiple group identities, self-awareness, empathy, and humility in interactions.
3. Ability to communicate clearly and act on feedback related to identity and equity.
4. Strong sense of accountability to equitable practices.
5. Understanding of how identity dynamics impact organizational culture.
6. Commitment to CHN and Planned Parenthood’s service ethos, workplace values, and standards.

$21 - $31.60 an hour

CHN believes in fair and equitable pay. The salary range varies based on education, experience, and other factors.

CHN offers a competitive benefits package including health coverage, flexible spending accounts, disability and life insurance, employee assistance program, retirement plan with employer match, and paid time off.

Clinical Health Network for Transformation (CHN) is an equal employment opportunity employer committed to diversity and inclusion. We encourage applications from all qualified individuals, including people of color and members of the LGBTQIA+ community.