Medical Billing Specialist

AR Collections Specialist - Mental Health & SUD Focused

*Must reside in the Eastern (ET) or Central Time (CT) Zone

Hours: 8:00am to 5:00pm ET

Pay ranges $21 to $23/hour

Advanced Recovery Systems is an integrated behavioral healthcare management company dedicated to the treatment of addiction, substance abuse, and mental health issues. We put behavioral health front and center, providing assistance to people with substance abuse issues, addictions and mental health concerns.

With facilities in various regions of the U.S., we have been furthering this mission since our inception, applying our advanced approach to patient care.

Every facility in the Advanced Recovery Systems network strives to provide the highest quality of care, using evidence-based therapeutic models that really work. Our goal is to help men and women live healthy, happy lives without the burden of substance abuse or mental illness.

Benefits include:

• Health, Vision, Dental, Employer-Matched 401(k)
• STD, LTD, and Employer-Paid Term Life Policy
• Employer Matched HSA – up to $1500 a year company contribution
• Employee Wellness Program – reduce employee premiums $40/mo
• Free MDLive telehealth benefit
• Paid Time Off - Vacation /Personal /Holiday/Sick
• Employee Referral Bonus

The AR Specialist will be required to complete Audits, Compiles and Create Claims for submission. Responds timely to address up front and backend rejections, working each claim billed until payment is received or deemed uncollectable.

CORE JOB DUTIES:

• Ability to work virtually in a remote capacity, adhering to set working schedule with periodic contact with management throughout the day via phone or via teams.
• Daily auditing of active and non-active clients to ensure proper program, authorization, diagnosis, and revenue elements have been captured.
• Communicating with department and hospital staff to address any issues related to billing and the accuracy of charge capture, insurance, authorization and billing.
• Addressing all rejected claims, merging, editing and ensuring proper filing is done in accordance with ARS’ billing rules.
• Ensuring all worklists assigned by management are up to date and compliant in terms of productivity and accuracy.
• Updating EMR and patient accounts when required, and opening IT tickets to address any issues that may cause delay in billing.
• Following up post submission for any third-party billing to ensure claim(s) are on file and set to pay.
• Resolving claims issues in which the payer has rejected the claim; by filing corrective claims, filing claim level appeals, providing additional information to the payer to support the claim, or advancing the claim(s) to the next level – UR appeal and/or Management.
• Documenting actions throughout the claim life cycle by entering notes within Avatar, Waystar, and BB Tech (Tool Kit).
• Identify claim rejection and denial trends, and bringing those trends to the attention of management.
• Attend AR meeting as needed and conducted by your management team.
• Apply standard improvement processes, follow-through (PDCA); Plan, Do, Check and Action.
• Maintain strict confidentiality, adhere to Part2 regulations and HIPAA guidelines.
• Follow all state regulations and adhere to all company policies and procedures.
• Other duties as assigned.

Requirements:
EDUCATION:

• Associates Degree Preferred. High School and GED required.

EXPERIENCE:

• Minimum of 3 years of experience in medical business matters at an Acute Hospital Organization, Physician practice, Behavioral Health Facility, or Medical Billing Company.
• Lean Six Sigma, Kaizen or other Lean Process Management experience a preferred asset, but not required.
• CPC, CPAT, or CPAM preferred, but not required.

EQUIPMENT:

• This role requires the employee to utilize their own personal computer, meeting expectations of the company's software and virus security standards.
• Windows 11 w/ latest Windows update installed. (Chromebooks and Apple computers are not compatible.)
• an “up to date” antivirus software.
• ARS does offer some reimbursement for remote office equipment.

PROFESSIONALISM & VIDEO CONFERENCING REQUIREMENTS:

• This is a remote position that requires regular participation in virtual meetings and video conferences. Team members are expected to have a stable internet connection, a distraction-free environment, and a functional webcam. As a representative of our organization, you are also expected to present yourself professionally during all video interactions—this includes dressing in appropriate, work-ready attire.

KNOWLEDGE/SKILLS/ABILITIES:

• State & Federal Statutes Regarding Patient Confidentiality laws; Drug-Free Workplace Policies; Workplace Violence; Corporate Integrity& Compliance Program;
• Customer and Personal Service; Mathematics; Education and Training; Clerical; Computers and Electronics; Reporting.
• Active listening, Speaking, Coordination, Social Perceptiveness, Critical Thinking, Judgment and Decision Making, Monitoring, Reading Comprehension.
• Deductive Reasoning, Inductive Reasoning, Written and Oral Expression, Problem Sensitivity, Written and Oral Comprehension, Speech Clarity and Recognition.
• Ability to work as part of a multidisciplinary team.
• Ability to communicate accurately and concisely, written and oral.
• Excellent interpersonal and telephone skills.
• Effective financial assistance in charge, billing capture and collection efforts to clients in treatment or transitioned/discharged.

Benefits:
We offer great benefits including 401(k), paid time off plan, medical, dental, vision, and much more.