Accounts Receivable Claim Specialist (Fully Remote)

Balance Health is the nation’s premier comprehensive lower-extremity focused Physician Practice located. Our team has an immediate need to hire a reliable, hard-working, experienced AR Claim Specialist. This is a full-time, fully remote role and will be responsible for reviewing claims activity for billing and submitting claims in the revenue cycle billing and claims functions. Manage billing, submissions, and successfully resolve billing forms from the clinics, surgery centers, and hospitals related to Balance Health. Will also be expected to identify and present improvement recommendations based on gathered knowledge and experience while working directly with the providers’ documentation and productivity. Determine and assess patient records, review accounts receivable activities, and collect payments. Responsibilities include clear and timely communication with clinicians on a regular basis.  This is a fully remote role open to candidates in the following states: AZ, CA, CO, FL, IL, MI, NC, NM, NV, SC, TX, UT, VA, WV. 

Our practice helps patients stay active and mobile by providing the best clinical care available across our network of locations. If you meet all the qualifications outlined below and want to join a great team, while committing to working a full-time schedule, we invite you to apply.

ESSENTIAL FUNCTIONS: 

• Analyze and follow up on rejected and/or unpaid claims according to established standards. 
• Work MGRHOLD and HOLD buckets as required by productivity measures.
• Reviews and appeals unpaid and/or denied claims with insurance carriers.
• Audit and Analysis of Regulatory Billing Practices.
• Determine accuracy of Insurance payments following up on any identified discrepancies.
• Run and build routine required and ad hoc reports.
• Efficiently monitors both Accounts Receivable (‘AR’) and Collections.
• Identifies and properly bills secondary or tertiary insurances.
• Responds to billing questions directly with patients and/or insurance companies using excellent people, phone etiquette, and excellent communication skills to ensure all parties receive all information necessary and timely.
• Ability to handle challenging situations with extreme patience and professionalism.

Performs miscellaneous job-related duties as requested or assigned 

QUALIFICATIONS: 

To be successful in this role, must be able to perform each of the essential functions noted above in addition to possessing the Education, Training, Knowledge, Skills, Abilities, and Expected Behaviors as follows:

Required:

• High-school  diploma or equivalent.
• Minimum  3-years of experience in a relevant AR role, including the following:
• Accurate interpretation of insurance EOBs (Explanation of Benefits)
• Handling medical claims, billing, payment postings, and insurance collections
• Knowledge and full understanding of all insurance guidelines, particularly with Medicare and Medicaid per current standards.
• Effective time management and organizational skills including prioritizing daily tasks.
• Ability to communicate logically and clearly verbally and in writing, along with good listening communication skills while maintaining professional and courteous interactions.
• Must be able to ensure accurate, timely completion of assigned tasks.
• Respectfully accepts coaching and guidance provided constructively to ensure continual improvement, career growth, and development.
• PC Proficient with good working knowledge of Microsoft Office, including Word, Excel, and Outlook.
• Understands additional tasks may be assigned to meet business needs.
• Legal eligibility to work in the United States without sponsorship now or in the future.
• Ability to successfully pass an in-depth background investigation, including clean DMV report and pre-employment drug screen.

Desired:

• Certified Professional Coder (CPC) a plus, but not required.
• Ancillary billing experience is preferred.
• Experience working in a medical practice environment.

or any combination of academic education and professional training and development along with applied work experience that demonstrates the ability to successfully perform the essential functions of the position.

Compensation / Benefits:

• Fully  remote full-time position working Monday – Friday with a  competitive pay range of $23 - $28 per hour depending on relevant work experience.
• Eligible to participate in company benefit program on the first of the month following 30-days of employment if a 30-hour work week is consistently maintained.
• Eligible to participate in our 401(k) program with company match on the first of the month following 2-months of employment.

Balance Health provides equal employment opportunities to all qualified applicants and employees without regard to any legally protected classes, including, but not limited to age, gender, gender identity, genetic information, marital status, medical condition, mental/physical disability, national origin, pregnancy, race/color, religion, sexual orientation, or military/veteran status.

If an offer of employment is extended and a candidate hired, proof of authorization to work in the US and/or U.S. citizenship must be provided.

PHYSICAL DEMANDS/ ENVIRONMENTAL FACTORS

This job description is not designed to cover or contain a comprehensive listing of duties or responsibilities that are required of the employee. Balance Health is proud to commit to an equal opportunity workplace, regardless of race, color, religion, sex, sexual orientation, ender identity, ancestry, citizenship, national origin, marital status, veteran status or disability. If you have a disability or special need that requires accommodation, please let us know.

• While performing the duties of this job, the employee is regularly required to sit; use hands for fine manipulation; and talk or hear.

• Prolonged periods of sitting at a desk and working on a computer

• Specific vision abilities required by this job include close vision, distance vision and depth perception

AMERICAN WITH DISABILITIES ACT (ADA) SPECIFICATIONS

Qualified individuals with disabilities may make a request for reasonable accommodation to the Director of Human Resources.  Upon receipt of an accommodation request, the Director of Human Resources will meet with the requesting individual to discuss and identify the precise limitations resulting from the disability and the potential accommodation that might help overcome those limitations. The Director of Human Resources in conjunction with a medical review (and, if necessary, other appropriate management representatives) will determine the feasibility of the requested accommodation and the impact on the business operation.  The Director of Human Resources will inform the qualified individual of the decision of the accommodation request or how to make the accommodation.  

Balance Health provides equal employment opportunities to all qualified applicants and employees without regard to any legally protected classes, including, but not limited to age, gender, gender identity, genetic information, marital status, medical condition, mental/physical disability, national origin, pregnancy, race/color, religion, sexual orientation, or military/veteran status. 

If an offer of employment is made, proof of authorization to work in the US and/or U.S. citizenship must be provided during first day of employment.

NOTE: This job description is not intended to be all-inclusive. It is intended to describe the general nature and level of work being performed by the employee assigned to this position.? An employee may be required to perform other related duties as assigned to meet the ongoing needs of the organization.  This job description is subject to change as the needs and requirements of the job change. 

Visit our website @ https://balancehealth.com/location/foot-and-ankle-associates-cupertino-ca
(Only qualified candidates will be considered and/or contacted.)
** NO PHONE CALLS OR RECRUITERS / STAFFING AGENCIES PLEASE **About Balance Health

Balance Health empowers people to live full lives by helping them improve and maintain mobility. We do this by bringing together leading podiatrists, orthopedic surgeons, vascular surgeons, and physical therapists and providing them the tools and resources necessary to deliver exceptional patient care. This mission has made us the fastest growing lower-extremity focused Physician Practice.