Payer AR Specialist II

Atrium Health - Rome, GA

Full-time - Mid Level

Rome, GA

Ambulatory Health Care Services

About the position

The Payer Accounts Receivable Specialist II at Atrium Health plays a crucial role in managing the payment status of claims submitted to assigned payers, which may include high-volume commercial and government payers. This position requires diligent follow-up with payer representatives to ensure that payments are received in a timely manner. The specialist will be responsible for tracking and completing follow-up tasks as they arise, ensuring that all accounts receivable are monitored effectively. In addition to these responsibilities, the specialist will also investigate and address any denials or refund requests that come from the assigned payers. This role demands strong organizational skills, as the individual must manage and prioritize multiple tasks to meet deadlines and departmental goals. As a Level II specialist, the individual will also be expected to train new employees, sharing knowledge and best practices to enhance team performance. The ability to recognize performance trends and recommend solutions to leadership is essential. The Payer Accounts Receivable Specialist II will report directly to the Supervisor of Post-Claim and will receive daily oversight from the Team Lead of Accounts Receivable and Denials. This position is vital in ensuring that the revenue cycle operates smoothly and efficiently, contributing to the overall financial health of the organization.

Responsibilities

• Monitor payment status of claims submitted to assigned payers.
• Follow up with payer representatives to ensure timely payment is received.
• Track and complete follow-up tasks as identified.
• Investigate and work on denials or refund requests from assigned payers.
• Manage and prioritize multiple tasks to meet deadlines and department goals.
• Train new employees and demonstrate the ability to recognize performance trends.
• Recommend solutions to leadership based on performance trends.
• Ensure tasks are managed and documented within practice management system work queues.
• Maintain productivity standards set by post-claim leadership team.
• Strive for a positive customer service experience.
• Maintain reception desk/work areas.
• Comply with all federal, state, or other regulatory requirements.
• Adhere to organizational policies and procedures for relevant location and job scope.

Requirements

• High school graduate or equivalent education required.
• 5 years or more experience in a physician billing office setting.
• Working knowledge of accounts receivable processes.
• Knowledge of Medicare, Medicaid, commercial insurance, workers' compensation, and other insurance industry operating procedures.
• Proficient computer skills, including Microsoft Outlook, Excel, and Word.
• Basic knowledge of medical terminology and prior experience with ICD-9 or ICD-10, CPT, and HCPCS coding is preferred.
• Proficiency in filing and collecting insurance claims from individual carriers or agencies.

Nice-to-haves

• Effective verbal and written communication skills.
• Self-motivated and able to work efficiently without direct supervision.
• Ability to prioritize and manage multiple tasks simultaneously.
• Ability to work well with others in a team environment.
• Demonstrated ability to use PC-based office productivity tools effectively.
• Dedication to high-quality customer service and maintaining a flexible customer service approach.