We’re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care.
Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians.
When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.
Please Note: We will only contact candidates regarding your applications from one of the following domains: @summithealth.com, @citymd.net, @villagemd.com, @villagemedical.com, @westmedgroup.com, @starlingphysicians.com, or @bmctotalcare.com.
Job Purpose: (AR) Specialist
This position serves to drive efficient, compliant, and effective claims and denials processing to optimize reimbursement for the organization. The responsibilities of this role include denied claims and A/R follow up with various payers including but not limited to the following: Commercial Insurances, Medicare, Medicaid, Uninsured Patients, Workers Compensation and First Aid, Occupation Medicine, and other reimbursement categories.
Essential Functions/Responsibilities
- Collect delinquent outstanding balances as quickly as possible by applying collection best practices as defined by the Standard Operating Procedures and training protocols and/or as defined by the AR manager
- Primary accountability for specific AR scope/function (for example: Commercial or Uninsured or Worker’s Compensation, etc.)
- Utilize various AR reports to target aged balances for collection in order to meet and maintain performance goals as set by Management.
- Evaluate denials and partial payments to determine if further reimbursement is valid
- Effectively participate during team meeting, payer discussions/meetings and conference calls/meetings as needed
- Research and correct cash application of misapplied funds and payments on patient accounts as necessary
- Identify and request adjustments to insurance and patient accounts as necessary, while following departmental procedures and policies related to overpayments and credits and refunds
- Ability to consistently maintain productivity and quality expectations as defined by management
- Alert management to irregularities, insurance trends and areas of concern with reimbursement
- Ability to maintain confidentiality of all information under HIPPA guidelines and policies and maintain PHI integrity
- Responsible for assisting in any new hire training within the AR Management team
- Responsible for assisting all new Rev Cycle cross-team members in the onboarding and training process to educate new CityMD employees on AR Management
- Assists other departments within the Revenue Cycle department with various tasks/duties as assigned
Qualifications
- High School Diploma, GED or Equivalent Required
- Minimum of 2-4 successful years in a business collection environment preferred
- Prior medical billing and healthcare insurance knowledge
- Intermediate MS Word, Excel, Google (GMAIL, G Drive) necessary
- Solid understanding of state laws and insurance fee schedules and their impacts on billing and collection
- Excellent oral and written communication skills
- Excellent organizational and multitasking skills
- Flexible and approachable to colleagues and inter-departmental stakeholders
- Ability to perform functions at established CityMD RCM Support Center
- Workers Compensation and No Fault prior billing experience a plus
Physical Requirements:
This job may require, from time to time, repetitive tasks.
Direct Reports:
None
Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD’s benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.
Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.
Our Company cares about the safety of our employees and applicants. Our Company does not use chat rooms for job searches or communications. Our Company will never request personal information via informal chat platforms or unsecure email. Our Company will never ask for money or an exchange of money, banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at select Our Company locations during regular business hours only. For information on job scams, visit, https://www.consumer.ftc.gov/JobScams or file a complaint at https://www.ftccomplaintassistant.gov/.
