AR Hospital follow Up (Remote)

AR Hospital follow Up

Cognizant is one of the world's leading professional services companies. We help our clients modernize technology, reinvent processes, and transform experiences, so they can stay ahead in our constantly evolving world. Do you thrive in a busy environment and are you able to multi-task successfully? If so, please apply today!

Shift: Monday to Friday

Location: Remote

Applications will be accepted until 6/7/2025

Job Description:

In this role, the successful candidate performs advanced level work related to resolution of hospital denials. This position will be responsible for root cause analysis hospital payer denials, experience in identifying procedures impacted by National Correct Coding Initiative Edits (NCCI), technical payer policies, appeal documentation and resolution. In addition, this position will be responsible for identification, collaboration, and implementation of process initiatives to reduce denials.

The Accounts Receivable Specialist role responsibilities include following up directly with payers to resolve claim issues and secure appropriate and timely reimbursement. Identify and analyze denials and payment variances and take action to resolve accounts including drafting and submitting technical appeals.

Key Responsibilities:

• Problem Solving: Use exceptional problem-solving and critical thinking skills to resolve accounts and meet quality and productivity standards.

• Billing Guidelines: Demonstrate knowledge of state/federal billing guidelines, reimbursement methodologies, and payer policies.
• Recommendations: Suggest additions, revisions, or deletions to work queues and claim edits to improve efficiency.
• Pattern Identification: Identify patterns in denials and escalate to management with sufficient information for follow-up.
• Excel Skills: Use Excel to summarize and provide detailed reporting to management and clients.
• Tracking and Trending: Track and trend claim denials and underpayments to identify improvement initiatives.
• Communication: Ensure all actions are documented, appeal letters are effective, and root causes are communicated clearly.

Preferred Qualifications:

• Experience: 2-3 years in healthcare revenue cycle.

• Education: HS Diploma. Associate or bachelor's degree preferred.

• Technical Skills: Proficiency in Excel, payer portals, and claims clearinghouses.

Additional Duties:

• Examine Claims: Analyze denied and underpaid claims to determine discrepancies.
• Follow-Up: Communicate with payers to resolve outstanding claims and ensure timely reimbursement.
• Regulatory Compliance: Maintain a thorough understanding of federal and state regulations and payer-specific requirements.
• Documentation: Document activity accurately including contact names, addresses, phone numbers, and other pertinent information.
• * Initiative and Resourcefulness: Make recommendations and communicate trends and issues to management.
• Problem Solving: Demonstrate strong problem-solving and critical thinking skills to resolve accounts and meet standards. Root Cause Analysis of Payment Issues: Ability to identify specific reasons for underpayments, denials, and cause of payment delay.
• A/R Issue Identification and Resolution Strategy: Works with management to identify, trend, and address the root causes of issues in the A/R.

Salary and Other Compensation:

The hourly rate for this position is between $19.00 - $21.60 per hour, depending on experience and other qualifications of the successful candidate.

This position is also eligible for Cognizant's discretionary annual incentive program, based on performance and subject to the terms of Cognizant's applicable plans.

Benefits: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:

• Medical/Dental/Vision/Life Insurance

• Paid holidays plus Paid Time Off

• 401(k) plan and contributions

• Long-term/Short-term Disability

• Paid Parental Leave

• Employee Stock Purchase Plan

Disclaimer: The hourly rate, other compensation, and benefits information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.