PMax - AR Denial Management Specialist

Resolv PracticeMax is seeking a skilled and experienced Accounts Receivable Representative to join our team. You will work within the team to manage accurate and timely claims follow-up and accounts receivable resolution.

What your impact will be:

• Call payer(s), utilize payer portals, utilize client clearinghouse and all other resources available to ensure resolution of outstanding claim balances.

• Update information in practice management software to ensure timely resolution of outstanding AR.

• Compile necessary information and drafts appeals to ensure resolution of denied claims.
• Coordinate duplicate billings, coordination of benefits, medical records or clinical documents as needed to expedite payment of insurance claims.
• Follow up with appropriate resource contacts to locate and obtain missing, invalid, or incomplete information.
• Act as key contributor to the Revenue Cycle by identifying and reporting inefficiencies and opportunities that enhance revenue flow, decrease denials, and minimize write-offs.
• Accountable for complex payers, aged claims, and special accounts receivable projects as assigned.
• Adhere to government regulations, payer contracts, insurance guidelines and practice specific agreements when performing insurance follow-up.
• Resolve inappropriate payments with insurance carriers that are not in compliance with payer contracts, practice agreements or governmental agency rates on individual accounts.
• Identify trends in payer non-compliance and inform management if not able to resolve with payer.

What we are looking for:

• Team player
• Problem solver
• Critical thinker
• Detail oriented
• Computer literate
• General knowledge of claims revenue cycle and medical terminology preferred.
• Highschool diploma or Equivalent

What we can offer:

• Opportunity for challenging projects and professional growth
• Vacation and personal days
• Comprehensive benefit package
• Lifestyle rewards
• Flexible work options

About us:

Resolv is a leader in Revenue Cycle Management and has been in business for 20+ years specializing in medical coding and billing.