📁
Corporate Support Center
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250000EM Requisition #

Passionate, driven people dedicated to making a difference in healthcare.

 

SpecialtyCare continues to grow and we’d like you to grow with us. We are the most experienced provider of outsourced clinical services in the industry, and we are always interested in building our team by hiring and training smart, dedicated people who share our values and our commitment to excellence.

 

Focused on Excellence

At SpecialtyCare, everyone makes a difference in the delivery of healthcare. Each of us, no matter the role, is important to the success of our company, the success of our customers, and the health of our patients. Exceptional care and positive patient outcomes require team members passionately dedicated to collaborating and driving excellence at every turn–from clinicians in the operating room to administrative people providing support behind the scenes. Highly successful companies need top talent in every position. And, with our outstanding work environment and our focus on people as one of our critical success factors, we are very committed to you, your career, and your success.

 
Job Summary

As an Accounts Receivable Representative you are responsible for identifying trends, analyzing, and working medical claim denials from commercial, multi-state Medicare and Medicaid, HMO/PPO and subrogation payers as assigned. 

  • Initiate collection follow-up on underpaid and denied claims with assigned payers through reconsideration forms, appeals or phone calls to the payer.
  • Research and resolve claim rejections.
  • Identify billing errors to be corrected by coding team.
  • Research insurance medical policies and guidelines.
  • Respond to payer correspondence in a timely manner.
  • Communicate payment or denial trends to management in a timely manner.
  • Document all follow up efforts and communication within practice management system.
  • Develop and maintain positive working relationship with team members.
  • Other projects as assigned.

Hourly Wage Estimate: $16.97 - $26.30 (Several factors, such as specific skill set, education level, certifications and years of experience, are considered to determine actual compensation.)

Requirements
  • One (1) year certificate from a college or technical school.
  • Three (3) years of related experience and/or training
  • Accounts receivable & experience working with payors, preferred.
  • Must be proficient with a computer and Microsoft Office, especially Excel.
  • Experience with PeopleSoft and JD Edwards is helpful.
  • Ability to read, analyze and interpret insurance policies and guidelines.

Knowledge & Skills

  • Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume.
  • Good understanding of debits and credits and the billing process.
  • Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
  • Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
  • Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
  • Ability to write reports, business correspondence, and procedure manuals.
  • Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
Physical Demands & Work Environment
The physical demands and work environment described here are representative of those that must be met by an associate to successfully perform the essential duties of this job, which may vary by location. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:
  • While performing the essential duties of this job, the associate is required to stand, walk, sit, use hands to grasp, handle or feel objects, tools or controls, reach with hands and arms, stoop, kneel, crouch, talk or hear. Hearing must be normal with or without correction.
  • Must be able to lift and/or move, push or pull 25 pounds or more.
  • Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus. Vision must be normal with or without correction.
  • Associates work in a business office setting.
  • Typical noise level is moderate.
  • Ability to work a minimum of eight (8) hours per day and longer if needed according to workload.
  • Ability to work in a demanding, fast paced environment.

The Successful Candidate

The successful candidate must bring a high level of ethical, intellectual, professional and personal values that complement the team and company vision.  The following competencies are highly valued:

  • Has high attention to detail with the ability to analyze information.
  • High energy, self-motivated individual whose style is effective in working with all levels of the organization to drive performance and continuous improvement using an analytical and metrics based approach.
  • Lives the SpecialtyCare Values – Integrity, Care, Urgency, and Improvement.
 
Benefits

We offer competitive compensation and a robust benefits package that includes health, dental, vision, and life insurance plans; generous paid time off; 401(k) with matching funds; tuition reimbursement; and professional development and membership allowances.

 
 
 

SpecialtyCare is an Equal Opportunity and Affirmative Action Employer
Employment with SpecialtyCare is at-will

 

SC Corp

 

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