Accounts Receivable Denials Representative

Job ID
2018-21743
Employment Type
full-time
City
Saddle River
Hours Per Week
0.00
State
NJ

Overview

The Accounts Receivable Denial Representative (ARDR) position is responsible for validating and recording patient accounting denial information, resolving obstacles to payment after a denial is received, and effectively overturning denials by assigning accounts to appropriate internal and external resources. In this position the candidate will work with the Supervisor of Accounts Receivable Denials to track all denials, provide clarity on root cause, and ensure that hospital clients have consistent, repeatable information, and effectively worked denials. The ideal candidate must have 5 or more years of experience in the healthcare reimbursement industry primarily working with both Commercial insurance and Managed Care carriers. The Accounts Receivable Denial Representative must also possess a strong knowledge and understanding of all line of business contracts.

 

Responsibilities

  • Identify and record the correct denial reason and value before initiating reprocess/appeal activity
  • Work assigned denials on a daily basis, according to project productivity and quality goals
  • Work with the PAR team to be sure that accounts are effectively brought to payment after a denial was resolved
  • Create and maintain a supportive relationship with management and clients
  • Communicate effectively with other departments within the company on client or payer changes that may impact their respective area
  • Keep current with all commercial and managed care pricing models, rules and regulations(including Medicare and Medicaid HMOs  and managed care pricing models, rules and regulations
  • Maintain a strong knowledge and understanding of all commercial payers within their specific project. (Including Medicare and Medicaid HMOs within their specific project
  • Maintain a thorough and current knowledge of denial reasons in the industry, their causes, and their proper resolution
  • Maintain confidentiality at all times

 

Qualifications

1-2 years of experience in a healthcare setting ( Hospital/Doctor's Office)

Abilty to review remits (EOB) 

Must be able to understand denial reasons

Must be able overturn denials through the appeal process

Must navigate through multiple systems and handle high call volume.

About nThrive

nThrive is the leader in providing end-to-end revenue cycle services, technology and education solutions. Previously known as MedAssets, Precyse, Equation and Adreima, each formerly a leader in its own right, we’ve combined our talents and capabilities into a single enterprise. At nThrive, we are people who are passionate about empowering health care for every one in every community. We work together to transform financial and operational performance, enabling health care organizations to thrive.
 
nThrive is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.

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