Manage claims and billing operations to ensure reimbursement efficiency while analyzing trends and providing exceptional customer service to improve processes.
Follow up on unpaid claims, resolve payment discrepancies, and manage accounts receivable to ensure timely reimbursement.
Collaborate with teams on appeals for denied claims and to update missing demographic or insurance information as needed.
Analyze denial trends and recommend and implement prevention strategies.
Post and reconcile payments and adjustments with accuracy and efficiency.
Resolve credit balances promptly while maintaining compliance with billing standards.
Review and research rejected claims to identify root causes and ensure timely resubmission.
Identify underpayments and escalate payer reimbursement variances for review and recovery.
Maintain accurate account documentation, follow-up notes, and status updates in billing systems
Partner with cross-functional teams to resolve billing challenges and implement solutions.
Provide excellent customer service to patients and stakeholders, addressing inquiries and concerns with professionalism and empathy.
Maintain productivity and quality standards for account follow-up, payment posting, and resolution timeliness.
Support additional duties, special projects, and initiatives as required.
Associates degree required.
1-3 years of relevant revenue cycle, medical billing, or accounts receivable experience required.
Experience posting payments, contractual adjustments, and reconciling accounts accurately.
Experience with accounts receivable follow-up, denial resolution, and appeals processing.
Experience interpreting adjustment and denial reason codes from ERA files and paper EOBs.
Understanding of insurance eligibility, coordination of benefits, and patient financial responsibility.
Experienced in claims processing systems and navigating payer websites and portals.
Strong attention to detail with the ability to prioritize and manage a high-volume workload.
Exceptional organizational, problem-solving, and communication skills.
Flexibility to adapt to new tools, processes, and team dynamics.
Experience in a start-up environment is a plus.
Artera.net builds AI-driven medical tests designed to personalize cancer therapy for patients. Aimed at enhancing decision-making for both patients and physicians, Artera is committed to improving cancer care on a global scale.
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