Cornerstone Building Brands is looking for a Senior Accounts Receivable Specialist to manage all follow-up and denial activities for commercial, governmental, and other payers. In this role, you will be responsible for resolving claim payment issues, securing timely reimbursement, identifying denial trends, and mentoring AR Specialist team members.
What You'll Do
- Perform all follow-up and denial activities.
- Follow up directly with commercial, governmental, and other payers to resolve claim payment issues and secure appropriate and timely reimbursement.
- Identify trends in denied payments by insurance companies to remediate issues.
- Identify changes with insurance company policies to ensure compliant billing.
- Communicate with other departments to resolve denial issues.
- Submit technical and clinical appeals in a timely manner.
- Mentor AR Specialist team members to help develop and improve their skills in the follow up, denials and appeals process.
- Follow up on clean claim delays from payors and add issues to escalation spreadsheets.
- Assist leadership with special projects for AR reduction and Cash Acceleration.
- Examine denied and other non-paid claims to determine reason for discrepancies.
- Demonstrate initiative in resolving complex claims and proactively make recommendations to management on trends.
- Communicate directly with payers to follow up on outstanding claims, file appeals, resolve payment variances, and ensure timely reimbursement.
- Provide guidance to other team members on resolving complex claims and filing appeals.
- Identify specific reasons for underpayments, denials, and payment delays.
- Work with management to identify, trend, and address root causes of issues in the A/R.
- Take meeting minutes for payor escalation calls and provide feedback to AR associates.
- Maintain a thorough understanding of federal and state regulations, as well as payer specific requirements.
- Document all 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.
- Review escalations from other areas to AR as well as accounts requiring escalation to other areas of Revenue Cycle.
- Assist the supervisor with DIBS calls as needed.
- Be a strong problem solver and critical thinker to resolve accounts.
- Meet productivity and quality standards as established by Ensemble.
- Perform other duties as assigned, including projects.
What We're Looking For
- Must demonstrate basic computer knowledge and proficiency in Microsoft Excel.
- Excellent verbal skills.
- Problem solving skills, the ability to look at account and determine a plan of action for collection.
- Critical thinking skills, the ability to comprehend tools provided for securing payment, and apply them to differing accounts.
- Adaptability to changing procedures and growing environment.
- Meet quality and productivity standards within timelines set forth in policies.
- Meet required attendance policies.
- External candidates must meet quality and productivity standards by day 90.
- Working knowledge of revenue cycle.
- CRCR, either upon hire or within 9 months of hire.
Nice to Have
- A 2 or 4-year college degree.
- 1 or more years of relevant experience in medical collections, physician/hospital operations, AR Follow-up, denials & appeals, compliance, provider relations or professional billing.
- Knowledge of claims review and analysis.
- Experience working the DDE Medicare system and using payer websites to investigate claim statuses.
- Working knowledge of medical terminology and/or insurance claim terminology.
Technical Stack
- Microsoft Excel
- Client host system
- DDE Medicare system
- Payer websites
Team & Environment
This role includes mentoring AR Specialist team members.
Benefits & Compensation
- Compensation: $16.00 - $20.00/hr based on experience
- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Comprehensive Benefits
- Career Advancement
- Associate benefits package supporting physical, emotional, and financial health
- Professional development investment and tuition reimbursement
- Quarterly and annual incentive programs
Company Culture
Our culture is rooted in collaboration, growth, and innovation. We put people first, last and always, strive for excellence, embrace new ideas, and maintain a customer obsession.
Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws.
