Senior Associate - GRS AR

Senior Associate AR are responsible for the resolution of errors, rejections and delinquent claims. The Associate AR resolves the claims by analyzing, auditing, and investigating their assigned client’s Accounts Receivable (A/R) process in order to ensure quality, resolve errors, and provide strategic solutions. Generally, supports a single practice management platform and specialty.

Essential Duties & Responsibilities

• Develop a solid understanding of assigned client’s process in order to strategically review and analyze their A/R functions
• Conduct regular audits of Medical Billing Specialist claim work for accuracy and quality; manages clean claim ratios for assigned clients
• Ability to read EOB & identify payments or denials and take end actions to resolve claims in entirety
• Call US insurances for status on claims Paid, denied, unresolved for further probing; so claims can be worked towards resolution with desired outcome
• Provide direction to Client Leads on claim audit corrections and resolution
• Prepare and analyze reports of audit reviews and performance issues with a focus on identifying trends, instituting continuous quality improvement initiatives, and identifying and providing on-going training opportunities for specialists
• Provide second-tier review on advanced and escalated claim issues to a satisfactory resolution
• Resolves outsource vendor’s escalates claims and claim rework
• Log all client issues encountered in internal tracking system, including enhancement requests, bugs, errors, and inquiries. Make management aware of any client issues or problems
• Modifies process and procedures to prevent claim rework through automation ideas
• Participate in continuing education of applicable software and hardware
• Assist with on‐boarding, development, training and mentoring of new hires and less‐experienced associates
• Assist Client Leads with, and participate in, end of month calls with customers and business partners

Experience andEducation

• Bachelor’s degree
• Minimum 36 months experience of US HC RCM AR function
• Medical billing knowledge and Healthcare experience preferred

Skills, Knowledge, and Abilities

• Knowledge of physician practice processes and workflow
• Strong verbal and written communication skills
• Strong analytical skills; ability to conduct research, creatively solve problems, and deal with ambiguity
• Independent, logical, strategic thinker with high focus and attention to detail
• Effective written and verbal communication and presentation style
• Able to read and interpret an Explanation of Benefits (EOB)
• Solid computer skills, especially Microsoft Outlook, Word, and Excel
• Able to manage a variety of tasks concurrently
• Strong customer service skills and interpersonal skills
• Dedicated, responsible, positive, and professional demeanor

Work Environment/Physical Demands

• While at work, this position is primarily a sedentary job and requires that the associate can work in an environment where they will consistently be seated for majority of the workday.
• This role requires that one can sit and regularly type on a keyboard majority of their workday.
• This position requires the ability to observe a computer screen for long periods of time to observe their own and others’ work, as well as in-coming and out-going communications via the computer and/ or mobile devices.
• The role necessitates the ability to listen and speak clearly to customers and other associates.
• The work environment is an open room with other associates and noise from others will be part of the regular workday