AR Recovery Analyst III (Medicaid)

About FinThrive

FinThrive is advancing the healthcare economy.
For the most recent information on FinThrive's vision for healthcare revenue management visit finthrive.com/why-finthrive.

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About the Role

Impact you will make

Reps typically demonstrate the aptitude and ability to take on critical processes while managing quality production standards. Acts as a mentor to Rep I& Rep IIassociates.Responsible for managing moderately complicated insurance denials and underpayments via theRubixisAR Follow Up software.

What you will do

• Learn and understand ourRubixisplatform and the various resources available
• Work an assigned number of accounts from start to finish successfully, and in a timely manner
• Call healthcare insurance companies, their affiliates & providers to resolve any question about contract or payment issues
• Analyze contract, billing, cash costing, pricing, and collections on accounts in compliance with billing regulations,policies,and
• procedures
• Investigate all insurance payments that deviate from expected payment
• Work collaboratively with leadership and other team members to confirm, challenge, or provide trending and solutions

What you will bring

• 5+ years Hospital Billing with follow up experience, with advanced knowledge of all pay or types, who will be able to manage day-to-day operational tasks associated with medical insurance billing and follow up
• Knowledge of Medicaid payer rules, processes, including how to interpret denial reasons, how to submit appeals to Medicaid payer, and access Medicaid portals
• Ability to use Medicaid Direct Data Entry (DDE) to submit claim corrections, adjustments, and inquiries as needed
• Detailed understanding of insurance follow-up (i.e.,resolving non-paid, denied, under-paid, and rejectedclaims) for healthcare providers
• Experience in UB04 Facility Pricing and Reimbursement variance
• Good understanding of revenue cycle
• Basic understanding of HIT systems like EPIC, Paragon,Zirmed,or other billing systems
• Problem solving / superior analytical skills
• An organized and detail-orientedaptitude

What we would like to see

• Bachelor's or associate degree
• 2+ years of experience in UB-04 Follow-Up and/or Contract/Reimbursement Analysis, including investigation of both pricing and reimbursement variances
• 2+ years of experience with Medicaid processes and systems
• Detailed knowledge of Facility Reimbursement contracts, fee schedules, reimbursement procedures

Advanced MS Excel skills

FinThrive's Core Values and Expectations

• Demonstrate integrity and ethics in day-to-day tasks and decision making, adhere to FinThrive's core values of being Customer-Centric, Agile, Reliable and Engaged, operate effectively in the FinThrive environment and the environment of the work group, maintain a focus on self-development and seek out continuous feedback and learning opportunities
• Support FinThrive's Compliance Program by adhering to policies and procedures pertaining to HIPAA, FCRA, GLBA and other laws applicable to FinThrive's business practices; this includes becoming familiar with FinThrive's Code of Ethics, attending training as required, notifying management or FinThrive's Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations

The physical demands and work environment characteristics described here are representative of those that a colleague must meet to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.