Accounts Receivable Analyst
- Review AR aging reports and work queues to identify unpaid and delayed claims.
- Follow up with third party payers, including commercial and government payers, on outstanding balances to understand claim status and payer requirements to adjudicate claim.
- Analyze claim status, remittance advice, and Explanation of Benefits (EOBs) to determine root causes of non-payment.
- Document claim status details and payer-provided information
- Provide account information to payers and required and resolve issues related to eligibility, authorizations, claim edits, coordination of benefits, and missing documentation.
- Rebill corrected claims and route issues to coding, billing, credentialing, denials, and/or clinical teams as needed.
- Review payments, contractual adjustments, denials, and patient responsibility balances to validate accurate account resolution.
- Adhere to defined SOPs and workflows and work within Epic Resolute Hospital Billing, claims clearinghouse, payer websites and portals, and other systems and required by workflows.
- Meet and exceed minimum productivity and quality standards; submit to performance improvement plans as required according to guidance from engagement management.
- Support team members in resolving complex claims.
- Support engagement management in pulling performance reporting.
- Ability to work independently and collaborate as part of a team
- Effective written and verbal communication skills
- Meticulous attention to detail and quality of work product
- Ability to build and sustain professional relationships
- Ability to lead projects or workstreams
- Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment
- Strong interpersonal skills and professional demeanor
- Ability to meet deadlines
- Ability to provide clear guidance to others
The team AI & Engineering leverages cutting-edge engineering capabilities to build, deploy, and operate integrated/verticalized sector solutions in software, data, AI, network, and hybrid cloud infrastructure. These solutions are powered by engineering for business advantage, transforming mission-critical operations. We enable clients to stay ahead with the latest advancements by transforming engineering teams and modernizing technology & data platforms. Our delivery models are tailored to meet each client's unique requirements. Our Industry Solutions offering provides verticalized solutions that transform how clients sell products, deliver services, generate growth, and execute mission-critical operations. We deliver integrated business expertise with scalable, repeatable technology solutions specifically engineered for each sector. Qualifications Required:
- Bachelor's degree in information technology, business, healthcare, or a related field; or equivalent experience
- 2+ years of experience in hospital accounts receivable follow-up operations or related revenue cycle functional area; intermediate proficiency in Epic Resolute Hospital Billing application; experience working according to high performing productivity and quality standards; experience working in claims clearinghouse system; familiarity with Epic Analytics and Reporting applications.
- Experience using Epic Resolute Hospital Billing
- Experience working in claims clearinghouse systems
- Experience using Epic Analytics and Reporting applications
- Ability to travel 10%, on average, based on the work you do and the clients and industries/sectors you serve.
- Limited immigration sponsorship may be available.
- Experience using Microsoft Word, Excel, and PowerPoint
- Experience supporting clinical or healthcare business operations
- Experience managing multiple projects or workstreams
- Experience preparing and delivering technical demonstrations
- Experience analyzing billing workflows, claim issues, or operational data
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