Accounts Receivable Analyst

JOB SUMMARY

The Accounts Receivable Analyst for Value-Based RCM, Inc. (VBRCM) is responsible for resolving third-party payer insurance denials as well as identifying trends and payer requirements in an effort to prevent future denials.

MAJOR AREAS OF FOCUS

  • Denial Resolution

  • Payer Rules and Regulations

RESPONSIBILITIES

  • Use, protect, and disclose patient protected health information (PHI) only in accordance with

  • Health Insurance Portability and Accountability Act (HIPAA) standards

  • Exhibit professional behavior and communication skills representative of VBRCM's commitment to superior customer service

  • Identify payment and denial trends and communicate to Supervisor and/or Team Lead

  • Handle payer and patient inquiries in a timely and detailed manner

  • Perform necessary follow-up to ensure timely resolution of appeals, obtain updated insurance information, identify and correct billing errors, etc.

  • Remain up to date on Medicare and Medicaid laws, HCFA requirements, contractual arrangements and other third-party payer requirements

  • Maintain current working knowledge of CPT and ICD-10 codes, required modifiers and encounter data

  • Apply knowledge of third-party payer guidelines in reviewing denied claims to ensure appropriate use of modifiers and CPT/ICD-10 codes

  • Enter detailed notes in the billing system

  • Utilize payer web sites and /or portals

  • Meet department productivity and quality standards

  • Perform other duties as assigned

KNOWLEDGE AND SKILLS

  • Working knowledge of CPT and ICD-10

  • Ability to work independently and as part of a team

  • Working knowledge of medical terminology preferred

  • Strong computer, typing and calculator skills

  • Excellent problem solving and communication skills

  • Ability and desire to work in a remote environment

  • Strong organizational skills and attention to detail

EDUCATION AND EXPERIENCE

  • High school diploma or GED

  • Previous medical billing experience required

JOB LOCATION

Remote

PHYSICAL REQUIREMENTS

  • Prolonged periods sitting at a desk and working on a computer

  • Must be able to lift up to 15 pounds at times