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A/R Resolution Specialist

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Job Details
Job Order Number
JC150305962
Company Name
Northern Light Health
Physical Address

Brewer, ME 04412
Job Description

POSITION SUMMARY:

This position is responsible for resolution of the unpaid AR by all
applicable payers of the EMHS Patient Account Services in a Centralized
Business Office environment. This position is responsible for resolving
outstanding payer balances in accordance with regulatory and contractual
obligations. This position requires a thorough understanding of the
requirements of the Government and Non-Government payment processing
policies. In addition, this position is held accountable to adhere to
the policies, procedures, and applicable laws; including metrics related
to productivity and quality. This position works closely with a team of
AR Resolution Specialists to analyze and take corrective action on
outstanding AR to ensure an optimum revenue cycle workflow.

DUTIES AND RESPONSIBILITIES:

? Resolve assigned accounts in a timely and accurate manner, which
maximizes reimbursement in compliance with payer regulations and the
department’s policy and procedures.
? Take necessary AR adjustments under the direction of the department’s
adjustment policy.
? Request relevant information from appropriate revenue cycle and
clinical departments as required by payer.
? Complete all returned requests from other departments each day.
? Ensure assigned discharged and final billed accounts are not aging and
are escalated timely.
? Advises management of payer processing issues which may require
attention in a timely manner.
? Meet or exceed the EMHS performance standards as it relates to quality
and productivity.
? Work closely by way of problem solving with peers and leaders to
address payer processing issues or changes that directly impact the
accounts receivable.
? Ensure all functions related to AR resolution supports the team goals
and objectives as well as EMHS’s financial performance objectives.
? Thoroughly understand the department’s key performance indicators.
? Actively participate in team huddles and meetings by way of sharing
knowledge, requesting information, and recommending process
improvements.

Professional Development:
? Maintain the knowledge of payer policies; complete AAHAM or other
healthcare related webinars.
? Attend internal education sessions to enhance or gain new skills.

Other:
? Perform other duties as assigned.
? Adhere to the professional image of EMHS as a competent and reliable
employee.

QUALIFICATIONS/EXPECTATIONS:

? High School diploma or equivalent required.
? At least one (1) year of healthcare claims AR resolution experience
preferred.
? Detailed knowledge of billing and payment rules and regulations in a
healthcare setting (Government and/or non-Government payers); multiple
hospitals/physician practices preferred.
? Knowledge of medical terminology, Current Procedural Terminology
(CPT), and International Classification of Disease (ICD) preferred.
? Experience with EMHS patient accounting software is preferred.
? Must possess strong problem solving skills.
? Ensures all AR resolution functions performed are compliant with
applicable laws and regulations.
? Excellent professional communication skills; both oral and written.
? Ability to understand payer processing policies and all applicable
billing rules and regulations to facilitate decision making.
? Proficient with Microsoft business applications.
? Customer oriented.
? Demonstrated ability to work independently and collaboratively.

FUNCTIONAL REQUIREMENTS and WORK ENVIRONMENT:

? Sedentary work requiring good manual dexterity. Work involves typing,
picking, grasping, occasional stooping, kneeling, crouching, lifting up
to 10 lbs., reaching and ability to move about to accomplish tasks.
Require repetitive motions of wrists, hands and fingers. Must have
excellent hearing and listening skills to receive detailed information
through oral communication (via telephone or in person).
? Employee subject to inside environmental conditions. Clean,
well-lighted, central heat, central air conditioning. Work is performed
in close proximity with others. Some noise level from office machines
(printers, typewriters, telephones). Ergonomically correct work
station.


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