Accounts Receivable Specialist

About Us: Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities. Come Join Our Team! As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe great work deserves great rewards. Help Us Grow Our Dream Team. Join Us, Refer a Friend, and Earn a Referral Bonus! Job Summary: Essential Functions and Tasks: - Follow up on claim rejections and denials to ensure appropriate reimbursement for our clients. - Process assigned AR work lists provided by the manager in a timely manner. - Write appeals using established guidelines to resolve claim denials with a goal of one contact resolution. - Identify and resolve denied, non-paid, and/or non-adjudicated claims and billing issues due to coverage issues, medical record requests, and authorizations. - Recommend accounts to be written off on Adjustment Request. - Report address and/or filing rule changes to the manager. - Properly notate patient accounts. - Review each piece of correspondence to determine specific problems. - Research patient accounts. - Review accounts and determine appropriate follow-up actions (adjustments, letters, phone insurance, etc.). - Process and follow up on appeals. File appeals on claim denials. - Inbound/outbound calls may be required for follow-up on accounts. - Respond to insurance company claim inquiries. - Communicate with insurance companies about the status of outstanding claims. - Meet established production and quality standards as set by Ventra Health. - Perform special projects and other duties as assigned. Education and Experience Requirements: - High School Diploma or GED. - At least one (1) year in the data entry field and one (1) year in medical billing and claims resolution preferred. - AAHAM and/or HFMA certification preferred. - Experience with offshore engagement and collaboration desired. Knowledge, Skills, and Abilities: - Intermediate level knowledge of medical billing rules, such as coordination of benefits, modifiers, Medicare, and Medicaid, and understanding of EOBs. - Become proficient in the use of billing software within 4 weeks and maintain proficiency. - Ability to read, understand, and apply state/federal laws, regulations, and policies. - Ability to communicate with diverse personalities in a tactful, mature, and professional manner. - Ability to remain flexible and work within a collaborative and fast-paced environment. - Basic use of a computer, telephone, internet, copier, fax, and scanner. - Basic touch 10-key skills. - Basic Math skills. - Understand and comply with company policies and procedures. - Strong oral, written, and interpersonal communication skills. - Strong time management and organizational skills. - Strong knowledge of Outlook, Word, Excel (pivot tables), and database software skills. Compensation: Base Compensation will be based on various factors unique to each candidate, including geographic location, skill set, experience, qualifications, and other job-related reasons. This position is also eligible for a discretionary incentive bonus in accordance with company policies.,