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Role Description

This role is responsible for follow up on unpaid, underpaid, or denied claims, tracking and resolving outstanding payment issues or variances, investigating and resolving denials and initiating and submitting appeals. Must be familiar with all EHRs, clearinghouses, payer portals, and accounting procedures and can manage daily financial transactions end-to-end. This position offers a unique opportunity to contribute to client success while making a meaningful impact on the healthcare industry.

• Perform follow up on unpaid and underpaid insurance claims and review claim status through payer portals, IVR systems and clearinghouses
• Manage work queue and meet productivity expectations
• Independently resolve denials including medical necessity, authorization, coding, payer policy disputes, and timely filing exceptions
• Execute formal appeals, including medical record review, narrative development, and payer escalation
• Analyze remittance to identify underpayments, takebacks, and payer trends
• Manage and maintain detailed records of all receivable transactions, including invoices, statements, and customer correspondence
• Monitor account details for non-payments, delayed payments, and other irregularities
• Comply with federal, state, and company policies, procedures, and regulations
• Perform day-to-day financial transactions, including verifying, classifying, and recording accounts receivable data

Qualifications

• High School Diploma or GED required, Associate’s or Bachelor’s degree in health information management or related field preferred
• Proven work experience in healthcare AR, Billing or revenue cycle
• Basic understanding of healthcare revenue cycle
• Strong attention to detail and willingness to learn payer rules
• Ability to follow structured processes and workflows
• Experience with appeals and denials resolution

Requirements

• Ability to manage complex, high-dollar, and aged AR accounts (e.g., >120 / >180 days)
• Experience with Medi-Cal and Medi-Cal Managed Care claims
• Experience in a high volume or managed service environment
• Willingness to travel once per quarter to a client location

Knowledge, Skills, and Abilities

• Ability to build strong relationships at all levels of the organization and provide exemplary customer service to patients
• Ability to listen effectively, as well as strong communication skills
• Must always demonstrate professionalism
• Ability to sit, stand and walk for extended periods of time

Benefits

• For salaried positions, this role may also be eligible for an annual performance bonus
• Additional benefits and perks may also be available, depending on the position and employment terms

Company Description

Impact Advisors, LLC is a nationally recognized healthcare management consulting firm delivering Best in KLAS advisory, implementation, and optimization services. We are driven by a commitment to exceed client expectations and are proud to be a trusted partner to many of the nation's leading healthcare organizations. Our mission to drive patient-centered, value-driven outcomes has earned us prestigious industry accolades.