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RCM AR Specialist

Company: Allscripts
Location: Escondido
Posted on: May 3, 2021

Job Description:

Welcome to Allscripts! Our Mission is to be the most trusted provider of innovative solutions that empower all stakeholders across the healthcare continuum to deliver world-class outcomes. Our Vision is a Connected Community of Health that spans continents and borders. With the largest community of clients in healthcare, Allscripts is able to deliver an integrated platform of clinical, financial, connectivity and information solutions to facilitate enhanced collaboration and exchange of critical patient information.

***This is a REMOTE opportunity***

The primary purpose of this role is responsibility for the overall recovery and management of accounts receivable as it relates to maximizing collections for clients. The position involves detailed research and follow-up on medical insurance claims and the careful preparation of appeals and responses to efficiently interact with insurance carriers and resolve the claim. The position supports the company's overall Operations and Client Services by efficiently and effectively driving the accounts receivable process and showing results.

Timely management and resolution of unpaid claims as assigned Effectively manage complex payer denials by assimilating and submitting: Supporting client clinical documentation Payer criteria Correct coding guidelines Specialty Association recommendations Federal/local regulatory guidelines Supporting letter of medical necessity from the provider of service Appeal letter consistent with payer requirements Other documentation as applicable Timely resolution of denials including follow up with payers and clients Responsibility for information necessary to resolve claims is the responsibility of the AR representative. Consistent and timely follow up with the client to provide clarification and/or missing information is critical. Adherence to the Client Adjustment Authorization matrix using appropriate adjustment codes to ensure clean AR Secondary claims management
Monitoring and reconciliation of claims to include:
Held vouchers Unbilled vouchers Patient balance report Credits and refunds Compliance with and enforcement of ASRCMS policies and procedures and Client specific billing guidelines Achieve goals set forth by supervisor regarding error-free work, transactions, processes and compliance requirements Specific goals include 1,400 accounts worked per month Other duties as assigned

Technical: Extensive knowledge on use of email, search engine, Internet and Microsoft products such as Outlook, Word and Excel; ability to effectively use payer and government websites.

Personal: Strong written, oral, and interpersonal communication skills; Ability to present ideas in business-friendly and user-friendly language; Highly self-motivated, self-directed, and attentive to detail; team-oriented, collaborative; ability to effectively prioritize and execute tasks in a high-pressure environment. Time management skills are critical.

Communication: Ability to read, analyze and interpret complex documents. Ability to respond effectively to sensitive inquiries or complaints from associates and clients. Ability to speak clearly and to make effective and persuasive arguments and presentations to senior management. Ability to write reports, business correspondence, financial forecasts and budgets.

Math & Reasoning: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent, and to interpret financial reports and graphs. Ability to use critical thinking skills to apply principles of logic and analytical thinking to practical problems.


High School Diploma or GED 3+ years of physician billing experience required Experience on the Epic or Allscripts practice management solutions is preferred

At Allscripts, our greatest strength comes from bringing together talented people with diverse perspectives to support the technology needs of 180,000 physicians, 1,500 hospitals and 10,000 postacute organizations across the globe. Allscripts offers a comprehensive compensation and benefits package, including holidays, vacation, medical, dental, and vision insurance, company paid life insurance and retirement savings.

Allscripts' policy is to provide equal employment opportunity and affirmative action in all of its employment practices without regard to race, color, religion, sex, national origin, ancestry, marital status, protected veteran status, age, individuals with disabilities, sexual orientation or gender identity or expression or any other legally protected category. Applicants for North American based positions with Allscripts must be legally authorized to work in the United States or Canada. Verification of employment eligibility will be required as a condition of hire.

From a "VEVRAA Federal Contractor" We request Priority Referral of Protected Veterans

This is an official Allscripts Job posting. To avoid identity theft, please only consider applying to jobs posted on our official corporate site.

Visa Sponsorship is not offered for this position

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Keywords: Allscripts, Escondido , RCM AR Specialist, Other , Escondido, California

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