The Revenue Cycle AR Specialist will analyze and review aged accounts to final resolution.
The candidate will work collaboratively with internal team members and contribute to a positive working environment and team spirit. A dedicated remote office space must be available with high-speed internet and peripheral equipment.
Required/Must have Qualifications:
- Minimum of 5 years' experience in revenue cycle processes:
- Within a hospital setting (UB04 format).
- Proficient in Expert level insurance follow-up, denials management, and credit balance resolution.
- Proficient to expert-level knowledge of Cerner Community Works and/or CPSI
- Demonstrate experience with reviewing outstanding balances to resolution (Medicare, Medicaid, and Commercial payors).
- Exceptional time management and organizational skills.
- Ability to direct work with minimal supervision and ability to meet performance and quality goals.
- High school diploma or GED required.
Primary Responsibilities:
- Works within payer portals, such as Availity, Optum, MMIS, and Medicare Contractors
- Understands payor contracts and can apply calculations to resolve under/overpayments.
- Knowledge of medical terminology such as CPT, HCPCS, APC, ASC, DRG and ICD10.
- Understands and ability to apply EOB.
- Submits reconsiderations and appeals related to denials using payor documentation and portals.
- Interacts with third-party payors and patients to resolve account balances.
- Ability to submit corrected claims billing.
- Reviews, researches, and resolves claim rejections to resolution.
- Uses standard work processes in daily work activities to ensure performance goals.
- Performs other duties as assigned.
Preferred Education:
- Associate or Industry Certification is a plus
- HFMA Certified Patient Accounts Representative (CPAR, ACPAR, or equivalent)
- Certified Revenue Cycle Representative (CRCR)
Core Perks and Benefits:
*HMO on your first day + Free coverage for 2 dependents on your 2nd year
*Government-mandated benefits
*20 Annual Leave Credits
*13th-month pay
Work Flexibility:
*WFH setup for this role
Onsite/Hybrid employee additional benefits:
*Travel Subsidy Allowance
*Free staff house accommodation (for those within a certain distance)
*Free Shuttle service
*Free Lunch
*Free Uniform
*Perfect attendance bonus
Additional benefits/perks to all employees
*Onboarding training
*Performance-based salary increase
*Discretionary incentives based on client or individual performance
*Monthly employee engagement
*Birthday Leave and Gift
*Weekly treats
*Christmas Hamper
*Anniversary Gift
*Opportunity to travel
Additional 20% night differential pay
Know someone who'd be perfect for this role? Refer them to us through the link below and get rewarded via Gcash for every successful hire:
- Grad trainees, junior, entry-level, and admin positions: PHP 3,000
- Intermediate positions: PHP 5,000
- Senior and hard-to-fill positions: PHP 8,000
Send them our way, and let's win together!
Check our website to see more:
And our Facebook page if you want more:
https://www.facebook.com/TheBackRoomOP
And here's the link to our Glassdoor page, where you can see what our team members have to say about us:
https://www.glassdoor.com/Reviews/The-Back-Room-Philippines-Reviews-E3846636.htm
"This position is exclusively open to Philippine citizens currently living in the Philippines. While remote work offers flexibility, please note that this role requires adherence to local regulations, making it suitable only for those based in the Philippines. We appreciate your understanding and look forward to receiving applications from qualified candidates who meet these criteria."
Philippines
