AR Team Lead - Behavioral HealthMedusind • Orlando, FL, US
AR Team Lead - Behavioral Health
Medusind • Orlando, FL, US
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- serp_jobs.job_card.full_time
job_description.job_card.job_descriptionUpdate claims status-move claims to appropriate Dept Escalated Claims Expertise and execution Rekick claims Resubmissions (NOF) Investigate billing / contract issues Investigate / confirm authorization details Identify Underpayments (contract rate not met). Investigate / Escalate / Reprocess denials Draft / Submit Written Appeals (TFL, non-covered services) Request Medical Records for appeal (med Rec Internal) Confirm cashed check status -Check tracers, balance bank-box Investigate / Resolve Contract issues notify CSM Negotiate SCA Rates Cross Training / SOP needs refinement Negotiate Front-End (Multiplan, GCS) & back end-low pay appeals Provide 91+ reporting (Determine scope / frequency) Research Specific Payer Issues and work with Payer Provider contacts Aging 120 special focus- Detailed report + Action plans Account Assignments & the "health" of that account Write off recommendations - to give to CSMs Work with India leadership to ensure A / R functions being performed in India are meeting SLA's, quality, production, etc. Bachelor’s degree in data Analytics, Business, Finance, Healthcare Administration, or related field (preferred). Behavioral Health RCM understands SUD / MH levels of care, and overall claims adjudication challenges. Strong understanding of AR follow-up strategies, payer reimbursement policies, and insurance claim adjudication processes. Proficiency in revenue cycle management platforms, workflow automation tools, and data analytics for AR tracking. Knowledge of HIPAA, Medicare, Medicaid, and payer regulations. Ability to work independently and collaborate with cross-functional teams. High level of accuracy, with the ability to set and maintain priorities in a fast-paced environment.
Job Description
Job Description
Description :
Medusind is a leading provider of revenue cycle management solutions to medical, dental, behavioral health, anesthesia, pathology, emergency, surgery, radiology, and other specialties. In January 2023, Alpine Investors, a people-driven private equity firm, invested in Medusind to continue to advance its leadership position as one of the top revenue cycle management companies in the country.
AR Team Lead is responsible to support the AR supervisor with claims follow-up, escalation, and troubleshooting activities related to the adjudication of all claims. This role is responsible for supporting a team and ensuring key performance indicators (KPIs) are met, including DSO, >
120 AR, and reducing write-offs. The ideal candidate has strong problem-solving skills, expertise in AR follow-up strategies, and a hands-on approach to improving claims adjudication success.
Key Responsibilities :
- Phone Calls / meetings with customers
- AR Follow-up- calls & portal
Claims Management :
Investigation & Troubleshooting :
Denials Management :
Continuous Improvement :
Requirements :
Educational Background :
Experience :
Expert Industry Knowledge :
Collaboration & Communication :
Detail-Oriented :
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Behavioral Team Lead • Orlando, FL, US
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