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AR Denial Specialist, CPC

Neurological Surgery

AR Denial Specialist, CPC

  • 530112
  • Medical Center
  • Neurological Surgery
  • Full Time
  • Opening on: Oct 5 2022
  • Grade 105
  • Job Type: Officer of Administration
  • Regular/Temporary: Regular
  • Hours Per Week: 35
 

Position Summary

An Accounts Receivable Specialist is responsible for collecting payments for unpaid claims by insurance company using skills in project management, organization and communications to collect the payments from clients and customers.  Accounts Receivable will be expected to secure revenue by verifying and resolving any claim discrepancies. The candidate must be organized and have a keen eye for detail to spot any issues that may arise.


Responsibilities

An Accounts Receivable Specialist has the following responsibilities:

  • Follow-up, review and research claim denials from insurance companies.
  • Serve as day-to-day liaison to agency’s third-party billing company
  • Reduce accounts receivable by reviewing claims rejected for coding.
  • Regular interaction and investigation of NSU accounts in EHR software.
  • Work with difficult insurance payers to ensure payments and maintain healthy relationships.
  • Communicate with payors and customers to request payment and arrange payment plans
  • Manage assigned accounts to determine needed action/next steps (charge correction, appeal, adjustment) based on EOB denial.
  • Responsible for working on complex coding denials.
  • Charge correct claims as needed where a modifier, CPT code, or ICD-10 diagnosis code need correction for resubmission.  
  • Initiate, develop affective letters of medical necessity (LMN) to appeal denied claims based on payer requirement and medical documentation.
  • Complete and submit approved reconsideration requests or appeals to insurance companies.
  • Document in detail all follow up activity in EMR and maintain records of promised payments and account statuses and follow -up timely
  • Assist in general A/R analysis to determine where edits and auto-adjustments will be required to improve workflows as needed
  • Identify payor denial trends by payor, CPT code(s), ICD-10 diagnosis code(s) and properly escalate to senior leadership
  • Engaging in ongoing educational opportunities to update job knowledge.
  • Operate in a team-oriented work environment.
  • Perform related duties as assigned within scope of practice.

Minimum Qualifications

  • Requires a bachelor's degree or equivalent in education and experience, plus four years of related experience.
  • must be CPC certified

Other Requirements

  • An ability to prioritize and manage expectations
  • A keen eye for detail
  • An ability to work independently
  • The ability to communicate articulately and efficiently with other people within the company
  • A mathematical background

Equal Opportunity Employer / Disability / Veteran

Columbia University is committed to the hiring of qualified local residents.

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