Essential Functions

• Research and investigate denied claims and contact carriers to problem solve & fully resolve claims in a timely manner to reduce Days in AR.
• Conduct claim scrubbing and submission & work claim edits.
• Proactively provide feedback to A/R Manager and team regarding denial trends or workflow issues impacting AR.
• Maintain strict confidentiality within medical practice and HIPAA compliance.
• Maintain productivity standards and goals set by the department and/or manager.
• Maintain standard quality measures and goals.

Core Competencies

• Accountability and Self-Management: Position is remote but will require traveling to corporate office for team meetings as required.
• Must be detail-oriented and organized.
• A self – starter capable of tracking to deadlines and meeting goals with little supervision required.
• A high level of analytical and problem-solving skills is expected.

Team Player

• Ability to work autonomously in a remote environment and as a team player, and approach challenges with a positive attitude.
• Strong working knowledge of Athena preferred (as well as online tools such as Availity and Optum Portal and various payer online portals).
• Excellent communication, customer service, and organizational skills, takes a proactive and professional approach to discussing issues and trends with manager and clinics.
• High attention to detail and moderate analytical and problem-solving skills is expected.
• Computer Skills – including Excel, use of sorting/filtering and pivot tables to analyze data.

Qualifications and Education Requirements

• High school diploma/GED. Coding Certification preferred.
• Coding experience STRONGLY preferred, but not required.
• Understanding of medical terminology, denial remark codes, medical coding knowledge, and experienced knowledge of ICD10, CPT, HCPCS codes and modifiers.
• Preferably 3 years prior experience in physician professional billing (Managed Care, Commercial and or CMS Part B claims adjudication), including any cross training in any other medical office roles such as front desk, insurance verification, referral coordination, etc.
• Must have experience with Explanation of Benefit forms (EOBs), insurance carrier billing requirements and medical policies, and credit balances (discounts and refund).

StrideCare offers a total rewards benefits package that includes:

• Major medical insurance
• Dental and vision
• 401k
• Long- and short-term disability
• PTO
• Paid holidays
• No weekends, evenings, nights, or holidays (paid holidays)
• Excellent work - life balance (Monday - Friday work schedules)
• Employee Assistance Program and more!