Revenue Cycle A/R Specialist (Hospital)(RCAR)

Revenue Cycle AR Specialist (Hospital)

The Revenue Cycle AR Specialist will analyze and review aged accounts to final resolution. 

Candidate will work collaboratively with internal team members and contribute to a positive working environment and team spirit.  A dedicated remote office space must be available with high-speed internet and peripheral equipment. 

Required Qualifications:

• Minimum of 5 years' experience in revenue cycle processes:
  • Within a hospital setting (UB04 format)
  • Proficient to Expert level insurance follow up, denials management, credit balance resolution
• Proficient to expert level knowledge of Cerner Community Works and/or MEDHOST
• Expert level experience within DDE/ FISS 
• Expert level experience working RTP Claims
• Proficient knowledge in Medicare Method II Billing, Coding & Follow Up
• Demonstrate experience with reviewing outstanding balances to resolution (Medicare, Medicaid, and Commercial payors)
• Exceptional time management and organizational skills
• Ability to direct work with minimal supervision and ability to meet performance and quality goals
• High school diploma or GED required
• Execute and fulfill JTS’ Remote Staff Agreement to ensure Security and Privacy 

Primary Responsibilities: 

• Works within payer portals, such as Availity, Optum, MMIS and Medicare Contractors 
• Understands payor contracts and can apply calculations to resolve under/overpayments
• Knowledge of medical terminology such as CPT, HCPCS, APC, ASC, DRG and ICD10
• Understands and ability to apply EOB
• Submits reconsiderations and appeals related to denials using payor documentation and portals
• Interacts with third party payors and patients to resolve account balances
• Ability to submit corrected claims billing
• Reviews, research, and resolves claim rejections to resolution
• Uses standard work processes in daily work activities to ensure performance goals
• Performs other duties as assigned

Preferred Education: 

• Associate or Industry Certification is a plus 
• HFMA Certified Patient Accounts Representative (CPAR, ACPAR or equivalent) 
• Certified Revenue Cycle Representative (CRCR) 

JTS Health Partners (JTS) is a healthcare professional services and analytics firm focused on Revenue Cycle Management (RCM), Health Information Management (HIM), Health Information Technology (HIT), Healthcare Analytics as a Service (AaaS) and Financial Technology (FinTech). JTS offers consulting, operational and analytical services that align with performance improvement initiatives of healthcare systems, hospitals and physician practices. 

At JTS, we create the “WOW” factor for each other and our clients. We embrace a culture where employees are empowered to be innovative and grow personally and professionally.

JTS is an Equal Opportunity Employer encouraging diversity in the workplace. All qualified applicants will receive consideration for employment without regard to race; color; religion; national origin; sex; pregnancy; sexual orientation; gender identity and/or expression; age; disability; genetic information, citizenship status; military service obligations or any other category protected by applicable federal, state, or local law. JTS makes hiring decisions based solely on qualifications, merit, business needs. 

JTS is a drug-free workplace and does conduct pre-employment drug testing.