Revenue Cycle AR Specialist

Summary

Transformations Care Network is a behavioral health organization committed to improving accessibility and the standard of care. The Cash Application Specialist supports revenue cycle operations by following up on unpaid and denied claims, resolving account issues, updating patient and insurance information, and documenting account activity. The role also analyzes payment patterns, processes adjustments, and collaborates with internal teams and payor representatives.

Responsibilities

• Initiate AR follow-up of all unpaid or denied claims with the appropriate Payor or Patient
• Resolve delinquent accounts in a timely manner by proactively working outstanding insurance accounts
• Obtains missing claim information to ensure prompt payment
• Research, appeal and resolve claim rejections/denials with the appropriate Payor
• Respond to written Payor communications as indicated with appropriate action in timely manner
• Update insurance and/or patient demographic information in the practice management system as required during follow up process
• Communicate payment or denial patterns that impact revenue to management in a timely manner
• Document daily in the practice management system all follow up and communication on a patient account in a consistent and concise format
• Processes adjustments when appropriate and in accordance with policies
• Maintain knowledge of mental health billing, department policies and procedures
• Develop and maintain positive working relationships with cross-functional teams, teammates and Payor representatives and other key stakeholders
• Consistently meet or exceed the department productivity and quality standards and performance requirements
• Collaborate as needed to identify and resolve underpayments and overpayments
• Other duties and responsibilities as assigned including but not limited to:
• Work overtime with little or no notice as needed
• Attend team meetings, phone conferences, and training as needed

Skills

• Minimum 1 year of physician billing experience
• High school diploma
• Self-starter; able to move own workflow along with minimal oversight
• Accurate; detail-oriented and able to meet tight turnaround times
• Strong written, verbal, and interpersonal communication skills
• Ability to exercise initiative, judgment, and decision-making skills
• Intermediate computer skills and proficiency in MS word, excel outlook and database management, and internet usage
• Nextgen experience is a plus
• This position is open to candidates across the United States. Based on TCN's current employment requirements, this role is not eligible to be performed in California, Colorado, Illinois, New York, or Oregon. Eligible work locations are subject to change
• 2-4 years of physician payment posting, billing, and accounts receivable in healthcare (preferred)
• Certified Revenue Cycle Representative or other billing certification (preferred)

Qualifications

Must Haves

• Minimum 1 year of physician billing experience
• High school diploma
• Self-starter; able to move own workflow along with minimal oversight
• Accurate; detail-oriented and able to meet tight turnaround times
• Strong written, verbal, and interpersonal communication skills
• Ability to exercise initiative, judgment, and decision-making skills
• Intermediate computer skills and proficiency in MS word, excel outlook and database management, and internet usage
• Nextgen experience is a plus
• This position is open to candidates across the United States. Based on TCN's current employment requirements, this role is not eligible to be performed in California, Colorado, Illinois, New York, or Oregon. Eligible work locations are subject to change

Nice to Haves

• 2-4 years of physician payment posting, billing, and accounts receivable in healthcare (preferred)
• Certified Revenue Cycle Representative or other billing certification (preferred)

Benefits

• Medical coverage
• Dental coverage
• Vision coverage
• Low-cost virtual care
• Dependent coverage
• Domestic partner coverage
• 401K
• Continuous learning guided by seasoned professionals to foster career growth
• Comprehensive onboarding and ongoing educational resources
• Incentive opportunities available for this role
• This position is open to candidates across the United States, except California, Colorado, Illinois, New York, or Oregon, subject to TCN's current employment requirements