Jorie AI

Accounts Receivable

• Perform A/R follow-up on outstanding claims across hospital, physician, inpatient, outpatient, and ambulatory settings
• Manage and resolve denials/appeals, claim edits, rejections, and rebilling with precision and timeliness
• Work extensively with Medicare accounts, ensuring compliance with all guidelines
• Navigate and resolve issues with other payors (experience helpful, but less extensive required)
• Utilize Meditech and Waystar systems to track, review, and manage claims efficiently
• Apply working knowledge of Novitas payor processes (preferred, not required)
• Generate reports and track trends using Microsoft Excel and MS Office Suite
• Communicate effectively with internal teams, external payors, and providers to resolve discrepancies
• Work independently in a remote setting while meeting performance standards and deadlines

Accounts Receivable Follow-Up Specialist

QA Engineer

• The Revenue Cycle Multi-Specialty Quality Assurance Specialist is responsible for evaluation and ensuring accuracy, and efficiency of end-to-end revenue cycle processes across various medical specialties
• Maintains quality standards related to eligibility verification/authorizations, charges, basic/minimal coding, billing, collections/reimbursement, payment posting, and patient billing
• Works with QA manager to identify improvement areas, perform root cause analysis, provide recommendations and assist with streamlining processes
• Conducts routine audits of end-to-end process assignments to ensure proper SOP/guidelines are met
• Evaluates eligibility verification and pre-authorization processes
• Evaluates basic coding, charge entry, billing, and claims processes, in addition to denied claims to ensure accuracy
• Identifies trends, root causes and system issues related to denials, no response, or underpayments
• Collaborates with management to develop and implement process improvement plans
• Maintains QA reports and completes timely weekly/monthly submissions

Accounts Receivable Follow-Up Specialist

Quality Assurance Specialist, Revenue Cycle – Multi-Specialty