AR Denial Reimbursement Specialist

Clarity Clinic is an interdisciplinary group private practice of Psychiatrists, Psychiatric Advanced Practice Providers (PAs, NPs), Psychologists, and Therapists. Our mission is to thoughtfully guide the whole person on their journey to find clarity and mental wellness by providing exceptional holistic care. Our staff of Psychiatrists, Advanced Practice Providers and Psychotherapists offer the latest medication, psychological assessment, and therapy treatment as we help guide our patients toward mental wellness and a balanced personal and professional lifestyle. Our team offers a broad range of specialties, services, and orientations to support and help all people regardless of their place in life. This multidisciplinary approach allows us to provide holistic care in psychiatry, psychotherapy and much more.

At Clarity Clinic, we are seeking an AR Denial Reimbursement Specialist to work in our Billing and Reimbursement department. The AR Denial Reimbursement Specialist must bring expert knowledge and experience to the team. They must follow all governmental regulations and payor contracts rules. They will be responsible for identifying lost revenue, decreasing denials and identifying revenue cash flow opportunities.

***This role is remote, but candidates must be based in the state of Illinois ***

In this role, you will: 

• Manage assigned AR worklist to ensure timely resolution of accounts.
• Manage and complete AR reports provided by management.
• Working patient and payor EOBs/correspondence in a timely manner
• Responsible for posting all $0 pay EOB/ERA files and reconciling daily batches.
• Performing appeals on denials, underpayments and/or non-paid claims
• Researching payor and government websites to ensure we are following payor billing and coding requirements and communicate these requirements and changes to the Billing team.
• Assist Cash Applications with payment corrections, and adjustments that need to be applied.
• Contact patients to collect and resolve outstanding balances. Identify and communicate problems/issues to management and teammates to foster timely correction and teamwork.
• Maintains appropriate working knowledge of coding, collections, insurance practices and business systems.
• Maintains a proven track record of high-volume claims research meeting collections goals.
• Work various tasks assigned as needed.
• Maintains the strictest confidentiality according to the guidelines of company policies.
• Stays abreast of and complies with all state and federal laws including HIPAA, ADA, OSHA, and FLSA.
• Attends meetings as required.
• Participates in development and training activities as required by management.
• Adapt to change in positive and professional manner.

Minimum Requirements:

• Minimum of 2 years’ experience in medical billing and collections.
• Minimum of 2 years of experience with CMS-1500 (02/12) charge entry, coding and batch filing.
• Minimum of 2 years of posting payments, analyzing accounts and managing denials of claims.
• Knowledge of CPT and ICD coding along with medical terminology.
• Extremely detail oriented with a high level of problem-solving skills.
• Ability to multi-task and work effectively within designated timeframes.
• Excellent interpersonal skills to communicate with both team members, patients and payors.
• Knowledge of and ability to adhere to HIPAA and privacy guidelines.
• Communicates effectively orally and in writing.
• Proficient with Word & Excel and Payor websites.