Accounts Receivable (AR) & Follow-Up Specialist

Summary

Clinical Health Network for Transformation (CHN) is a collaboration of Planned Parenthood affiliates focused on supporting high-quality, affordable care and health equity. CHN is seeking an Accounts Receivable and Follow-Up Specialist to manage revenue cycle accounts receivable, collect outstanding payments, resolve denials and rejections, maintain accurate records, and ensure billing compliance.

Responsibilities

• Ability to perform all duties for a Billing Specialist
• Handle complex accounts for both follow-up, appeal, and credit balance resolution
• Follow up on unpaid claims to collect outstanding balances. Investigate and resolve claim denials by reviewing medical records, coding, and payer contracts
• Ability to write and submit escalated appeal letters and represent compelling case to overturn denials with payors, following all billing and compliance regulatory guidelines
• Reviewing daily clearinghouse rejections, resolving, and alerting management of any trends in claim rejections
• Maintain detailed and accurate patient financial records, documenting all account notes and actions taken
• Work with healthcare providers to obtain necessary medical documentation, referrals, or authorizations required for claim processing and reimbursement
• Ability to follow-up on multiple payor types and across multiple states for Commercial, Medicare
• Medicaid, Medicaid Managed Care, Blue Cross, Title X, etc
• Review aged accounts, coordinates and escalates any denial and appeal projects with payors
• Achieve established key performance indicators (KPIs) for position
• Communicate effectively with insurance companies, patients, and healthcare providers to resolve billing issues and ensure accurate claim submission
• Assist Manager to resolve issues and provide support and guidance to the revenue cycle team
• Ensure compliance with all CHN and affiliate policies, as well as all state and federal regulations
• Demonstrates a commitment to CHN and Planned Parenthood’s mission related to health equity, especially centering racial equity, and deep sense of accountability to community
• Demonstrates a commitment to learning about and enhancing practices related to racial equity and the impact of structural racism on healthcare systems
• Provides positive and development feedback and accountability related to practices including, but not limited to, equity

Skills

• • Bachelor's degree in healthcare administration or equivalent experience
• • Minimum of 2 years of relevant account receivable experience
• • Previous experience using ICD-10 Medical Coding and Current Procedural Terminology (CPT)
• • Knowledge of medical terminology
• • Strong analytical and problem-solving abilities
• • Proficiency with Microsoft software (Excel, etc.)
• • Demonstrated ability to maintain a customer-centric service approach in a fast-paced environment
• • Excellent written and verbal communication skills and ability to collaborate and interact with all levels within and outside of CHN if necessary
• • Strong attention to detail and follow-up; and ability to multi-task in fast-paced environment
• • Demonstrated dedication to Planned Parenthood's mission, vision, and values
• • Strong interpersonal skills and the ability to build relationships with stakeholders
• • Excellent time management, and problem-solving skills
• • Commitment to advancing race (+) equity in one's work: interested in expanding knowledge about the role that racial inequity plays in our society
• • Awareness of multiple group identities and their dynamics, bringing a high level of self-awareness about personal identity, empathy, and humility to interpersonal interactions
• • Demonstrated ability to communicate clearly and directly as well as hear and act on feedback related to identity and equity with the aim to learn
• • Strong sense of accountability to equitable practices
• • Understanding of the impact of identity dynamics on organizational culture
• • Commitment to CHN and Planned Parenthood's In This Together service ethos, workplace values, and service standards
• • Strong General Technology Skills: proficient utilization of Excel, Word, and Windows • environment, Epic, eCW, NextGen or other practice management systems experience a plus
• • Willingness to travel in accordance with the needs of the position, as outlined in the essential functions. Compliance with all CHN travel policies, including safety guidelines while operating a personal vehicle
• • Medical Billing and Coding certification, Certified Revenue Cycle Representative (CRCR) or other certification a plus

Qualifications

Must Haves

• • Bachelor's degree in healthcare administration or equivalent experience
• • Minimum of 2 years of relevant account receivable experience
• • Previous experience using ICD-10 Medical Coding and Current Procedural Terminology (CPT)
• • Knowledge of medical terminology
• • Strong analytical and problem-solving abilities
• • Proficiency with Microsoft software (Excel, etc.)
• • Demonstrated ability to maintain a customer-centric service approach in a fast-paced environment
• • Excellent written and verbal communication skills and ability to collaborate and interact with all levels within and outside of CHN if necessary
• • Strong attention to detail and follow-up; and ability to multi-task in fast-paced environment
• • Demonstrated dedication to Planned Parenthood's mission, vision, and values
• • Strong interpersonal skills and the ability to build relationships with stakeholders
• • Excellent time management, and problem-solving skills
• • Commitment to advancing race (+) equity in one's work: interested in expanding knowledge about the role that racial inequity plays in our society
• • Awareness of multiple group identities and their dynamics, bringing a high level of self-awareness about personal identity, empathy, and humility to interpersonal interactions
• • Demonstrated ability to communicate clearly and directly as well as hear and act on feedback related to identity and equity with the aim to learn
• • Strong sense of accountability to equitable practices
• • Understanding of the impact of identity dynamics on organizational culture
• • Commitment to CHN and Planned Parenthood's In This Together service ethos, workplace values, and service standards

Nice to Haves

• • Strong General Technology Skills: proficient utilization of Excel, Word, and Windows • environment, Epic, eCW, NextGen or other practice management systems experience a plus
• • Willingness to travel in accordance with the needs of the position, as outlined in the essential functions. Compliance with all CHN travel policies, including safety guidelines while operating a personal vehicle
• • Medical Billing and Coding certification, Certified Revenue Cycle Representative (CRCR) or other certification a plus

Benefits

• Health Care Coverage (Medical, Dental, & Vision); eligibility for full-time, regular employees on date of hire
• Flexible Spending Accounts and Health Savings Account
• Short-Term Disability and Basic Life & AD&D Insurance provided by CHN
• Voluntary elections for Long Term Disability and Additional Life & AD&D Insurance available at cost
• Employee Assistance Program
• Retirement Plan, 3% employer match after one year of service
• Paid Time Off Program includes accrual-based PTO, Health Time Off (HTO), and nine (9) paid Holidays