Montana Veteran Jobs

Accounts Receivable Specialist (remote)

This is a remote position open to any qualified applicant in the United States.

The successful candidate performs advanced level work related to resolution of physician claim denials. This position will be responsible for root cause analysis physician payer denials, experience in identifying procedures impacted by National Correct Coding Initiative Edits (NCCI), technical payer policies, appeal documentation and resolution. In addition, this position will be responsible for identification, collaboration, and implementation of process initiatives to reduce denials.

Job Duties:

The Accounts Receivable Specialist role responsibilities include following up directly with payers to resolve claim issues and secure appropriate and timely reimbursement. Identify and analyze denials and payment variances and take action to resolve account including drafting and submitting technical appeals.

· Examine denied and underpaid claims to determine the reason for discrepancies.

· Communicate directly with payers to follow up on outstanding claims, file technical appeals, resolve payment variances, and ensure timely reimbursement.

· Ability to identify with specific reason underpayments, denials, and cause of payment delay.

· Works with management to identify, trend, and address the root causes of issues in the A/R.

· Maintain a thorough understanding of federal and state regulations, as well as payer-specific requirements and take appropriate action accordingly.

· Document activity accurately including contact names, addresses, phone numbers, and other pertinent information.

· Demonstrate initiative and resourcefulness by making recommendations and communicating trends and issues to management.

· Needs to be a strong problem solver and critical thinker to resolve accounts. Must meet productivity and quality standards.

Highlights:

Possess basic knowledge of entire RCM process with 2-3 years’ experience working in RCM specifically collections

Recognizes problems or trends and provides suggestions to help find resolutions

Strong knowledge of medical terminology, CPT codes, modifiers, and diagnosis codes and specific carrier requirements/knowledge

Ability to follow up on outstanding AR

Ability to review, interpret EOBs 835/837 and respond using medical guidelines and policies

Prioritize pending claims from aging basket and follow up at regular intervals to collect outstanding

Knowledge in writing appeals and following thru appeals process

Resolve accounts to get paid with max 2 touches

Communicates with leadership regarding specific reimbursement issues

Strong analytical skills and ability to meet assigned deadlines

Exceptional problem solving and critical thinking skills to root cause denials and resolve accounts. Must meet quality and productivity standards.

Demonstrates knowledge and expertise in state/federal billing guidelines, reimbursement methodologies, and payer policies.

Makes recommendations for additions/revisions/deletions to work queues and claim edits to improve efficiency to reduce denials and underpayments.

Exceptional Excel skills to summarize and provide detailed reporting to management and client.

Tracks and trends claim denials and underpayments to identify initiatives for payer, process or technology improvement plans.

Strong communication skills both verbal and written to ensure all actions taken are documented, appeal letters are effective, and root cause is communicated.

Salary and Other Compensation:

Applications will be accepted until March 27, 2025.

The annual salary for this position is between $46,000-65,000 depending on experience and other

qualifications of the successful candidate.

This position is also eligible for Cognizant’s discretionary annual incentive program, based on performance and

subject to the terms of Cognizant’s applicable plans.

Benefits: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:

• Medical/Dental/Vision/Life Insurance

• Paid holidays plus Paid Time Off

• 401(k) plan and contributions

• Long-term/Short-term Disability

• Paid Parental Leave

• Employee Stock Purchase Plan

Disclaimer: The salary, other compensation, and benefits information is accurate as of the date of this posting.

Cognizant reserves the right to modify this information at any time, subject to applicable law.

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