Accounts Receivable Representative

The Stepping Stones Group, LLC; United States; On-site; USD 42,000 - 62,000; Full time

Job summary

The Stepping Stones Group, LLC is seeking a Billing & AR Representative to support cash collections by timely billing, correcting rejections, and managing denials. The role emphasizes strong attention to detail, teamwork, and data-driven decision making across payer guidelines and clearinghouses.

Responsibilities include scrubbing billing records, generating claims, correcting errors, and addressing denials to ensure timely payments across assigned offices.

Qualifications

• Experience in behavioral health claims billing and denial management.
• Experience billing within a practice management system; Central Reach preferred.
• Experience with insurance payer guidelines and clearinghouses (Waystar/Zirmed preferred).
• Experience in a fast-paced, target-driven environment.
• Experience aggregating data to report trends and communicating findings.
• Experience with payer portals and calling payers for information.

Responsibilities

• Review and scrub billing records for insurance clients to ensure payer guidelines are met before claim submission.
• Generate claims for submission in adherence with payer guidelines.
• Correct claim errors flagged by PM system and release to clearinghouse promptly.
• Review and correct rejected claims, providing feedback to prevent repeats.
• Work denials in the clearinghouse and monitor aging to 90 days.
• Review total AR for assigned offices and action payers not processed via clearinghouse.

Skills

Attention to detail

Organizational skills

Teamwork

Customer service

Payer guidelines

Data analysis

Multitasking

Clear communication

Proactive

Microsoft Office

Tools

Waystar/Zirmed

Job description

Billing & Accounts Receivable Representative

Role-Based Mission:

In this critical role, the Billing & AR Representative enables cash collections through timely submission of billing, correction of rejections, and management of denials.

Outcome Measures:

• · Maintain zero denials in work queue for clearing house and identify trends to prevent subsequent denials
• · Maintain and assist the team with 30 day or less approach for denials sitting in clearing house buckets
• · Take proactive action on more than 90% of outstanding balances aged less than 90 days with no denial on record or unclear denial

Role-Based Competencies:

• · Work Ethic: Maintains a high level of professionalism and integrity when handling sensitive patient and insurance information
• · Organization and planning: Demonstrates consistent reliability and accountability in meeting deadlines and managing workload
• · Aggressiveness: Assertively escalates unresolved issues to ensure client access to care is not delayed
• · Attention to detail: Accurately enters and verifies patient insurance data, authorization requirements, and coverage limitations
• · Efficiency: Manages multiple requests simultaneously while maintaining quality
• · Intelligence: Understands complex payer policies, benefit structures, and authorization protocols
• · Fast paced and data driven: We treat speed as a competitive advantage. We use data, but we don’t get stuck in it. We make decisions and move on to the next obstacle.
• · Persistence: We demonstrate tenacity and are willing to go the distance to finish the job.
• · Enthusiasm: We exhibit passion and excitement for our work. We maintain a “can-do” attitude.
• · Follow-through on commitments: We live up to verbal and written agreements, always.
• · Flexibility/adaptability: We adapt quickly to changing priorities and conditions. We cope effectively with complexity and change.
• · Teamwork & customer service: We like working together. We reach out to peers and cooperate with supervisors to establish collaborative working relationships. We do our work with a focus on customer service, recognizing that “customers” includes our clients and their families, our frontline team members and candidates, and our community

Responsibilities:

• · Review and scrub billing records for insurance clients, ensuring that payer guidelines are met prior to generating a claim for submission
• · Generate claims for claim submission, ensuring that claims are generated in adherence with payer guidelines
• · Correct all claim errors that are flagged by the practice management system and release claims to the clearinghouse in a timely manner
• · Review and correct all claims that reject by the clearinghouse or the payer, ensuring that feedback is looped back to prevent repeat rejections from occurring if there are trends identified
• · Work all denials in the clearinghouse that are tied to your billing submissions, ensuring that trends are communicated to appropriate teams and denials aren’t aging out past 90 days
• · Review total AR for assigned offices to ensure that payers who aren’t processed via the clearinghouse are being actioned on in a timely manner
• · Other duties as assigned.

Job Qualifications:

• · Behavioral health claims billing and denial management experience. ABA-specific billing experience highly preferred
• · Experience billing within a practice management system. Central Reach experience preferred
• · Experience working within insurance payer guidelines
• · Experience working within a clearinghouse. Waystar/Zirmed experience preferred
• · Experience working in a fast paced, target-driven environment
• · Experience aggregating data to report and communicate trends
• · Experience calling out to payers to obtain information on billing submissions or denials
• · Experience navigating payer portals
• · Experience partnering internally, with both clinical and non-clinical teams
• · Experience with Microsoft Office products
• · Ability to multitask and maintain a strong work ethic
• · Self-motivated, proactive, independent, and detail-oriented

The Stepping Stones Mission Together, we are transforming the lives of children and families, improving the quality of therapeutic and behavioral services, and joining with like-minded therapists, clinicians and educators in order to have a greater impact in our communities. Our passionate leadership team and expansive clinical support network ensure the delivery of the highest quality therapeutic and behavioral health services nationwide.