Associate AR are responsible for the resolution of errors, rejections and delinquent claims. The Associate AR resolves the claims by analyzing, auditing, and investigating their assigned client’s Accounts Receivable (A/R) process to ensure quality, resolve errors, and provide strategic solutions.  Generally, supports a single practice management platform and specialty.

Essential Duties & Responsibilities

• Develop a solid understanding of assigned client’s process in order to strategically review and analyze their A/R functions
• Conduct regular audits of Medical Billing Specialist claim work for accuracy and quality; manages clean claim ratios for assigned clients
• Ability to read EOB & identify payments or denials and take end actions to resolve claims in entirety
• Call US insurances for status on claims Paid, denied, unresolved for further probing; so claims can be worked towards resolution with desired outcome
• Prepare and analyze reports of audit reviews and performance issues with a focus on identifying trends, instituting continuous quality improvement initiatives, and identifying and providing on-going training opportunities for specialists
• Log all client issues encountered in internal tracking system, including enhancement requests, bugs, errors, and inquiries. Make management aware of any client issues or problems
• Modifies process and procedures to prevent claim rework through automation ideas
• Participate in continuing education of applicable software and hardware
• Assist with on‐boarding, development, training and mentoring of new hires and less‐experienced associates

Experience and Education

• Bachelor’s degree
• One (1) to three (3) years months prior experience of US HC RCM AR Function
• Medical billing knowledge and Healthcare experience

Skills, Knowledge, and Abilities

• Strong verbal and written communication skills
• Strong analytical skills; ability to conduct research, creatively solve problems, and deal with ambiguity
• Independent, logical, strategic thinker with high focus and attention to detail
• Effective written and verbal communication and presentation style
• Able to read and interpret an Explanation of Benefits (EOB)
• Able to understand the cause of various denials and should be able to resolve them
• Solid computer skills, especially Microsoft Outlook, Word, and Excel
• Able to manage a variety of tasks concurrently
• Strong customer service skills and interpersonal skills
• Dedicated, responsible, positive, and professional demeanor

Work Environment/Physical Demands

• While at work, this position is primarily a sedentary job and requires that the associate can work in an environment where they will consistently be seated for the majority of the workday
• This role requires that one can sit and regularly type on a keyboard the majority of the workday
• This position requires the ability to observe a computer screen for long periods of time to observe their own and others’ work, as well as in-coming and out-going communications via the computer and/or mobile devices
• The role necessitates the ability to listen and speak clearly to customers and other associates

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Disclaimer: This Job Summary indicates the general nature and level of work expected of the incumbent(s). It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent(s) may be asked to perform other duties as requested. Greenway Health, LLC is an Equal Opportunity Employer. We do not discriminate on the basis of race, religion, age, gender, national origin, sexual orientation, disability, or veteran status.