Job description

Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, and now radiology, through the recent combining of forces with Advocate RCM

Focused on Revenue Cycle Management and Advisory services, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities

Job Summary

The Accounts Receivable (AR) Specialists are primarily responsible for analyzing collections, resolving non-payables, and handling bill inquiries for more complex issues

AR Specialists are responsible for insurance payer follow-up ensuring claims are paid according to client contracts

Complies with all applicable laws regarding billing standards

Essential Functions And Tasks

Follows up on claim rejections and denials to ensure appropriate reimbursement for our clients

Process assigned AR work lists provided by the manager in a timely manner

Write appeals using established guidelines to resolve claim denials with a goal of one contact resolution

Identified and resolved denied, non-paid, and/or non-adjudicated claims and billing issues due to coverage issues, medical record requests, and authorizations

Recommend accounts to be written off on Adjustment Request

Reports address and/or filing rule changes to the manager

Check the system for missing payments

Properly notates patient accounts

Review each piece of correspondence to determine specific problems

Research patient accounts

Reviews accounts and determines appropriate follow-up actions (adjustments, letters, phone insurance, etc,)

Processes and follows up on appeals

Files appeals on claim denials

Inbound/outbound calls may be required for follow-up on accounts

Respond to insurance company claim inquiries

Communicates with insurance companies about the status of outstanding claims

Meet established production and quality standards as set by Ventra Health

Performs special projects and other duties as assigned

Education And Experience Requirements

High School Diploma or GED

At least one (1) year in the data entry field and one (1) year in medical billing and claims resolution preferred

AAHAM and/or HFMA certification preferred

Experience with offshore engagement and collaboration desired

Knowledge, Skills, And Abilities

Intermediate level knowledge of medical billing rules, such as coordination of benefits, modifiers, Medicare, and Medicaid, and understanding of EOBs

Become proficient in the use of billing software within 4 weeks and maintain proficiency

Ability to read, understand and apply state/federal laws, regulations, and policies

Ability to communicate with diverse personalities in a tactful, mature, and professional manner

Ability to remain flexible and work within a collaborative and fast-paced environment

Basic use of a computer, telephone, internet, copier, fax, and scanner

Basic touch 10 key skills

Basic Math skills

Understand and comply with company policies and procedures

Strong oral, written, and interpersonal communication skills

Strong time management and organizational skills

Strong knowledge of Outlook, Word, Excel (pivot tables), and database software skills

Ventra Health

Equal Employment Opportunity (Applicable only in the US)

Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization

We strive for inclusiveness and a workplace where mutual respect is paramount

We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status

We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions

Recruitment Agencies

Ventra Health does not accept unsolicited agency resumes

Ventra Health is not responsible for any fees related to unsolicited resumes

Solicitation of Payment

Ventra Health does not solicit payment from our applicants and candidates for consideration or placement

Attention Candidates

Please be aware that there have been reports of individuals falsely claiming to represent Ventra Health or one of our affiliated entities Ventra Health Private Limited and Ventra Health Global Services

These scammers may attempt to conduct fake interviews, solicit personal information, and, in some cases, have sent fraudulent offer letters

To protect yourself, verify any communication you receive by contacting us directly through our official channels

If you have any doubts, please contact us at Careers@VentraHealth

com to confirm the legitimacy of the offer and the person who contacted you

All legitimate roles are posted on https://ventrahealth