Revenue Cycle AR & Denials Specialist

Scotlandhealth; Laurinburg (NC); On-site; USD 42,000 - 54,000; Full time

Job summary

Scotland Memorial Hospital is seeking a Patient Account Representative to join the Patient Financial Services team. Primary duties include reviewing denied and underpaid claims, communicating with payers, and analyzing denial trends to improve AR performance.

Responsibilities involve maintaining payer contact information, ensuring HIPAA compliance, and supporting quality improvement initiatives. The role requires collaboration with internal departments and participation in training programs as

Qualifications

• Examine denied and underpaid claims to determine discrepancies.
• Provide payers with reasons for suspected underpayments and analyze denial reasons.
• Identify root causes of denials and propose reduction strategies.
• Maintain up-to-date payer contact information.
• Ensure HIPAA compliance in handling patient information.
• Participate in continuous quality improvement initiatives.
• Cross-train in other Patient Accounts areas and attend training.
• Communicate with payers and internal departments via phone and email.

Responsibilities

• Examine denied/underpaid claims to identify discrepancies.
• Explain payer denials with specific reasons to payers.
• Analyze payer denial patterns with management to reduce AR.
• Maintain accurate payer files with contacts and websites.
• Handle payer and department communications by phone and email.
• Support continuous quality improvement by attending huddles and tracking progress.
• Cross-train in other Patient Accounts areas.
• Follow HIPAA guidelines while handling patient data.

Skills

Denied claims

Underpaid claims

Payer communication

Root cause analysis

HIPAA compliance

Quality improvement

Team collaboration

Job description

Scotland Memorial Hospital is seeking a Patient Account Representative to join the Patient Financial Services team. Primary duties include reviewing denied and underpaid claims, communicating with payers, and analyzing denial trends to improve AR performance.

Responsibilities involve maintaining payer contact information, ensuring HIPAA compliance, and supporting quality improvement initiatives. The role requires collaboration with internal departments and participation in training programs as