Accounts receivable
: Job Details :

The AR Specialist will be responsible for managing the accounts receivable including denied and underpaid claims for behavioral health services. The ideal candidate must have a strong understanding of AR processes, healthcare billing, particularly within the behavioral health setting, and be familiar with regulatory standards like HIPAA and HCPCS/CPT/ICD-10 coding.

Essential Job Duties and Responsibilities

· Review outstanding AR to determine necessary action.

· Investigate and resolve denied or unpaid claims by communicating with insurance companies, patients, and internal team.

· Utilize payer portals to maximize reimbursement.

· Prepare and submit denied claims as targeted project files to payers when necessary.

· Identify problematic claim trends and contract violations, report findings to the RCM Manager.

· Submit appeals as necessary.

· Contact payers regarding recoupment payments, overpaid accounts, and missing checks; initiate dispute process as needed and report all findings to the RCM Manager.

· Review underpayments and overpayments, summarize findings and report to the RCM Manager.

· Update insurance information in patients accounts as necessary.

· Work in conjunction with other billing staff to ensure timely filing.

· Attend departmental meetings/conference calls.

· Provide feedback to management as needed.

· Understands and adheres to Sanctuary Recovery Centers compliance standards.

· Performs other duties as assigned.

Qualifications: Education, Experience, and Skills

Required:

· High school diploma or equivalent.

· 5+ years of medical billing experience.

· Strong understanding of Arizona healthcare billing, particularly behavioral health services.

· Strong problem-solving skills to handle denied claims efficiently.

· Knowledge of HCPCS, CPT, ICD-10 coding, and medical terminology.

· Working knowledge of Kipu EMR Software and ADS Medics Premier (preferred)

· Working knowledge of CMS guidelines, contracted insurance guidelines and coding policies.

· Advanced proficiency in Microsoft Excel and Word.

· Detailed oriented, reliable, and able to multi-task in a fast-paced, high-volume work environment.

· Ability to maintain a high level of confidentiality by adhering to the HIPAA guidelines and regulations.

· Must have excellent written and verbal communication.

· Must have a valid driver license and be 18 years of age or older.

· Must be able to pass a background check.

· Must be able to pass substance abuse testing.