AR Specialist (ARSPC-04)

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The Accounts Receivable (A/R) Specialist is responsible for working directly with payers to ensure that payments are received in a timely manner. The A/R Specialist also identifies and resolves complex claims issues adversely impacting the revenue cycle management process, ensuring timely resolution through coordination, reconciliation, and effective denied claim management. The A/R Specialist follows internal and external policies and procedures, ensuring proper revenue is booked by monitoring payments, fee schedule changes, health plan reimbursement changes, and other aspects that impact revenue, cash collections, and adjustments. The A/R Specialist role requires an individual with strong analytical, problem-solving, meta-data skills, and an informal leadership ability to help effectively guide, delegate and support the A/R team.

Duties and Responsibilities:

• Ensures proper follow-up is performed on the back-end aspects of the revenue cycle process related to reimbursement, including projects, problem and issues escalation, and research
• Analyzes billing and claims for accuracy and completion; submits claims to proper insurance entities and follows up on any issues in a timely and effective manner
• Collaborates with other staff/departments to obtain and analyze additional member information to document and process billing, in alignment with department policies and protocols
• Analyzes trends impacting charges, coding, collection, and accounts receivable, and takes appropriate action to re-align staff and partner in the revision of policies and procedures, as needed
• Stays current with carrier rule changes and distributes the information within the department in a timely and effective manner
• Maintains a working knowledge of all health information management issues such as HIPAA and any/all health regulations
• Monitors health plan response files to ensure appropriate action is occurring, including timely posting of files to the system
• Ensures accurate reimbursement is being received for services rendered
• Analyzes system data and reports, making recommendations to improve processes as needed
• Remains up to date with current coding and billing regulations and compliance requirements
• In addition, all other duties as assigned

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At New Freedom, we restore lives and reintegrate communities through intentional guidance by providing our members with a sense of identity, purpose, and hope. We are growing and always looking for others who believe in our mission and have a heart to serve. Join our AMAZING team, apply now! We’re fulfilling our mission thanks to the dedicated work of our amazing employees. We provide them with a valuable total rewards package that includes:

• Competitive pay rates – including shift differential for eligible shifts/positions
• Comprehensive medical coverage (including dependents/family) – majority company-paid
• Short Term Disability, Life Insurance, Employee Assistance Program – company-paid
• 401K
• Dental, Vision, and Supplementary Insurance – available at low cost to employees
• Paid Time Off
• Paid Sick Time
• Paid Holidays – including 2 extra Floating Holidays
• Even more perks provided by the company, include:
  • 10-hour shifts with three days off – for eligible departments/positions
  • Onsite meals, snacks, and drinks – complimentary for employees
  • Onsite gym services – complimentary for employees
  • Onsite professional training opportunities/certifications/continuing education

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Additional Notes:
New Freedom Ops LLC is an Equal Opportunity Employer, a drug free workplace, and complies with Veteran and ADA regulations as applicable.

Experience

• Effectively demonstrates versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm
• Effectively collaborates and works within a team, while also effectively demonstrating the ability to take initiative and work well individually
• Intermediate computer skills – MS Office (Excel, Word, Outlook, Teams), Internet, Electronic Health Record, etc.
• Demonstrates a thorough understanding of behavioral health billing codes, AHCCCS/Medicaid, CMS guidelines, and current coding and billing regulations and compliance required
• Five (5) years of claims/billing submission experience in a behavioral health or healthcare setting or equivalent combination of education, training, and/or experience required

• Experience in submitting claims through a 3rd party system preferred

Education

• High School or better in General Studies or related field
• HS Equivalency or better in General Studies or related field

Licenses & Certifications

• APS Verification
• Criminal Background Check
• Annual TB Clearance
• Drug & Alcohol Testing

• Driver's License
• MVR Clearance

Skills

• Behavioral Health Experience
• Computer/Technology Literacy
• Claims/billing submission experience
• Behavioral health billing code experience
• AHCCCS/Medicaid, CMS & coding/billing regs
• Ability to sit for prolonged periods

Behaviors

• Dedicated: Devoted to a task or purpose with loyalty or integrity
• Team Player: Works well as a member of a group
• Functional Expert: Considered a thought leader on a subject
• Enthusiastic: Shows intense and eager enjoyment and interest
• Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well

Motivations

• Self-Starter: Inspired to perform without outside help
• Goal Completion: Inspired to perform well by the completion of tasks
• Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.