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A/R Claims Resolution Specialist in Providence, RI at Acadia Healthcare

Date Posted: 4/25/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Experience:
    At least 1 year(s)
  • Date Posted:
    4/25/2019

Job Description

Overview

Under the supervision of the Assistant Business Office Director, the A/R Claims Resolution Specialist is primarily responsible for identifying and resolving claims issues.  Experience with provider appeals, including renegotiating claims if the need arises. Should have strong customer service and communications skills, a good understanding of the revenue cycle and knowledge of computer software and medical insurance.

The right candidate will possess a strong knowledge of medical claims submission, in an office that uses more automated than manual systems.  Must have the ability to work efficiently both independently and as a team. The CBO is a fast paced environment and staff must be committed to producing the highest quality of work. Looking for someone with an outgoing and “can do” attitude. Candidate should be self-motivated and up for the challenge of getting the job done.

About Acadia Healthcare:

(Nasdaq: ACHC) Acadia Healthcare is a provider of inpatient and outpatient behavioral health and addiction treatment services. Acadia operates a network of 270+ behavioral healthcare facilities with approximately 10,000+ beds in 40+ US states, the United Kingdom and Puerto Rico. Acadia provides psychiatric and chemical dependency services to its patients in a variety of settings, including inpatient psychiatric hospitals, residential treatment centers, outpatient clinics and therapeutic school-based programs.

We offer a competitive benefits package to all full-time employees including Medical, Dental, Vision, 401k, Company paid group term life insurance.

Responsibilities

A/R Claims Resolution Specialist Responsibilities:

  • Identify root cause of insurance denials
  • Strive to minimize lost revenue by maintaining knowledge of payer policies
  • Maintain and grow payer relationships
  • Monitor aged claims reports and work closely with peers and leaders to solve problems
  • Actively participate in team meetings to share knowledge, request information and recommend process improvements
  • Knowledge of insurance guidelines, including HMO, PPO, Medicare, and state Medicaid
  • Evaluate and investigate payer matters for any discrepancy in payments as necessary
  • Follow-up on payer specific appeals and denial of claims.
  • Other duties as assigned

Job Requirements

Qualifications

To perform the essentials of the A/R Claims Resolution Specialist position competently, an individual must be able to perform each task within this position effectively and efficiently. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Position Requirements

  • 3+ years of medical billing/revenue cycle experience preferred
  • Experience reading electronic claim files
  • Knowledge and competency to use medical claims clearinghouse systems
  • Must be a self-starter
  • Possess strong organizational and follow up skills.
  • Proficient with Microsoft Office products.
  • Ability to work under tense deadlines.
  • Ability and willingness to work as part of a team.
  • Familiarity with HCFA 1500 & UB-04
  • Strong oral and written communication and interpersonal skills.
  • Ability to prioritize and multi task a large work volume with a high level of efficiency and attention to detail.
  • Dependable and able to work independently.
  • Willing to adjust schedule to meet work demands.
  • Detail-orientated.