Accounts Receivable Specialist (remote) Position Available In Kennebec, Maine

Accounts Receivable Specialist (remote) at Cognizant in Augusta, Maine, United States Job Description Accounts Receivable Specialist (remote) This is a remote position open to any qualified applicant in the United States. The successful candidate performs advanced level work related to resolution of physician claim denials. This position will be responsible for root cause analysis physician payer denials, experience in identifying procedures impacted by National Correct Coding Initiative Edits (NCCI), technical payer policies, appeal documentation and resolution. In addition, this position will be responsible for identification, collaboration, and implementation of process initiatives to reduce denials.

Job Duties:

The Accounts Receivable Specialist role responsibilities include following up directly with payers to resolve claim issues and secure appropriate and timely reimbursement. Identify and analyze denials and payment variances and take action to resolve account including drafting and submitting technical appeals.

• Examine denied and underpaid claims to determine the reason for discrepancies.
• Communicate directly with payers to follow up on outstanding claims, file technical appeals, resolve payment variances, and ensure timely reimbursement.
• Ability to identify with specific reason underpayments, denials, and cause of payment delay.
• Works with management to identify, trend, and address the root causes of issues in the A/R.
• Maintain a thorough understanding of federal and state regulations, as well as payer-specific requirements and take appropriate action accordingly.
• Document activity accurately including contact names, addresses, phone numbers, and other pertinent information.
• Demonstrate initiative and resourcefulness by making recommendations and communicating trends and issues to management.
• Needs to be a strong problem solver and critical thinker to resolve accounts.

Must meet productivity and quality standards.

Highlights:

Possess basic knowledge of entire RCM process with 2-3 years’ experience working in RCM specifically collections Recognizes problems or trends and provides suggestions to help find resolutions Strong knowledge of medical terminology, CPT codes, modifiers, and diagnosis codes and specific carrier requirements/knowledge Ability to follow up on outstanding AR Ability to review, interpret EOBs 835/837 and respond using medical guidelines and policies Prioritize pending claims from aging basket and follow up at regular intervals to collect outstanding Knowledge in writing appeals an