AR Analyst Standardization and Refining AR Process

AR Analyst Standardization and Refining AR Process Job Description Duties: Macro AR Aging & Trend Analysis: To identify root-cause bottlenecks and plan focused cleanup efforts, conduct ongoing diagnostics on accounts receivable aging distributions. Systemic Denial Root-Cause Diagnosis: To find recurrent, high-volume denial patterns and apply preventative front-end remedies, do forensic assessments of incoming insurance remittance files. High-Value & Complex Claim Adjudication: Take personal responsibility for auditing, contesting, and settling high-value or extremely complex clinical claims that call for more sophisticated policy interpretation than the typical telephone follow-up scripts. Underpayment & Contract Compliance Auditing: To find, record, and contest concealed underpayments or incorrect contractual modifications, compare incoming insurance payments with agreed-upon charge schedules. Operational Inventory Direction: To improve recovery efficiency, slice, arrange, and distribute bulk aging inventory into highly optimized process lists and assign the AR Calling squad specific execution targets. Focus Skills: Advanced US Healthcare RCM & Claim Lifecycle Fluency: Thorough comprehension of the whole US healthcare billing chain, including clearinghouse routing networks, commercial versus government payer behaviors, and CMS-1500 layout guidelines. Advanced Data Diagnostics & Spreadsheet Analytics: High-level proficiency with data manipulation in monitoring spreadsheets to extract useful insights from massive billing datasets. Medical Coding, Modifier, and Taxonomy Literacy: Proficient working knowledge of fundamental medical coding structures, such as advanced billing modifiers, CPT procedural codes, HCPCS frameworks, and ICD-10 diagnostic records. Forensic Appeal Generation & Contract Compliance: Outstanding capacity to create well-organized, evidence-based medical appeal letters and put together tangible medical record packages to reverse intricate payer denials. Apply now to become an integral part of our growing team! With Regards, HR - Maria