Accounts Receivable

• Monitor and manage assigned payor accounts to ensure timely follow-up and resolution of outstanding claims.
• Analyze payor trends and denial patterns to identify root causes and recommend process improvements.
• Communicate effectively with insurance companies to resolve claim issues, including denials, underpayments, and rejections.
• Coordinate capably with outsourcing partners to streamline processes, enhance efficiency, maintain compliance, ensure quality control, cost-effectiveness, and timely delivery of services.
• Monitor payor responses and response timelines for adherence to contractual parameters.
• Collaborate with internal departments such as coding, billing, and patient access to ensure claims are submitted accurately and compliantly.
• Escalate unresolved payor issues to leadership with appropriate documentation and recommendations.
• Maintain detailed documentation of all payor interactions and claim resolution activities in the AR system.
• Maintain current knowledge of payor policies, contract terms, and regulatory changes affecting reimbursement.
• Participate in payor meetings and contribute to contract negotiations by providing data-driven insights.
• Meet or exceed performance metrics related to AR aging, denial resolution, and cash collections.
• Serve as the primary expert on third-party payor collection processes, policies, and regulatory requirements.
• Develop and implement strategies to reduce AR aging and improve collection rates from commercial, government, and managed care payors.
• Lead initiatives to streamline workflows, enhance system functionality, and improve staff productivity.
• Provide training, coaching, and mentorship to AR staff on payor-specific collection techniques and denial resolution.
• Act as a liaison with payor representatives to resolve escalated issues and advocate for timely reimbursement.

Accounts Receivable, Third Party RCM

Molecular Specialist

Post-Bar Clerk/Associate