Accounts Receivable Specialist

Company Description

Ventra Health is positioned to solve hospital-based providers’ most pressing financial and operational challenges by building on the foundation of our three founding companies.

Ventra Health provides subject matter expertise, local payer knowledge, economies of scale, and best in class technology to ensure your success.

• Clients across 48 states
• 400 physician practice clients 
• 40 hospital and health system clients 
• Network of 11,000 providers

• 6 million annual Anesthesia cases
• 9 million annual Emergency Medicine visits 
• 1,300 employees across the U.S.
• Industry leading, cloud based technology
• Powerful patient engagement platform

OUR Mission

We enable healthcare providers to thrive by solving their business challenges.

Our Vision 

To simplify the business of healthcare.

Job Description

The Accounts Receivable (“AR”) Specialist is responsible for payer follow-up on claims.  AR specialists are expected to complete work on time as assigned by the Revenue Cycle Manager (“RCM”) Manager.  An AR Specialist must comply with applicable laws regarding billing standards and be able to operate in a team-oriented environment that strives to provide superior service to anesthesia providers throughout the country.

Essential Functions and Tasks:

• Follow up on all assigned insurance claims to ensure appropriate reimbursement for our clients.
• Process assigned AR work lists provided by the manager.
• Develop plan to complete work lists by assigned due date.
• Call plans on work lists for claim status.
• Reviews accounts to determine appropriate follow-up action.
• File appeals on claim denials and underpayments as appropriate.
• Recommend accounts to be written off on Adjustment Request.
• Reports address and/or filing rule changes to the manager.
• Check system for missing payments.
• Properly notates patient accounts.
• Review each piece of correspondence to determine specific problems.
• Research patient accounts.
• Take appropriate actions (adjustments, letters, phone insurance, etc.).
• Scan correspondence and index to the proper account.
• Answer telephone according to team requirements.
• Route client calls to the appropriate RCM
• Respond to insurance company claim inquiries.
• Meets daily production goals as assigned by management.
• Other duties as assigned.

Qualifications

• High School Diploma or GED.
• One year in data entry field.
• One year in medical billing, anesthesia preferred.
• Intermediate level knowledge of medical billing rules, such as coordination of benefits, modifiers, Medicare and Medicaid and understanding of EOBs.
• Basic written and verbal communication skills.
• Ability to make decisions in a timely fashion that are sound, accurate and supported by the reasoning and inclusion of appropriate people.
• Must be able to interact well with all kinds of people.
• Must be able to prioritize and accomplish objectives in a timely fashion.

Additional Information

All your information will be kept confidential according to EEO guidelines.