Key Responsibilities:
Accounts Receivable (AR) Follow-Up
Monitor and manage assigned accounts receivable, ensuring timely follow-up on unpaid claims to reduce AR days.
Contact insurance companies, patients, or other stakeholders to resolve payment issues and secure outstanding payments.
Review aging reports regularly to prioritize high-dollar and aged claims, ensuring prompt action on delayed reimbursements.
Denial Management and Resolution
Analyze denied claims to identify reasons for denial and develop corrective actions for each case.
Research and gather supporting documentation to resubmit or appeal denied claims, ensuring compliance with payer requirements.
Work closely with billing and coding teams to address coding or documentation issues contributing to denials and prevent future occurrences.
Claim Reconciliation and Documentation
Ensure accurate claim reconciliation by confirming payments are posted correctly and identifying discrepancies for resolution.
Maintain comprehensive records of follow-up actions, denials, appeals, and resolutions for tracking and reporting purposes.
Update patient accounts and internal systems to reflect the latest status of claims and any adjustments made.
Performance Monitoring and Reporting
Track and report on AR metrics, including denial rates, AR aging, and claim resolution timelines, providing insights to management on trends and areas for improvement.
Contribute to monthly or quarterly AR performance reviews, highlighting successes and identifying opportunities for process improvements.
Participate in audits and quality assurance initiatives, ensuring compliance with industry standards and payer guidelines.
Collaboration and Process Improvement
Collaborate with the billing, coding, and client services teams to address root causes of denials, such as coding inaccuracies or missing documentation.
Provide feedback to RCM leadership on denial trends and suggest improvements to reduce recurring issues, contributing to overall process optimization.
Stay updated on payer requirements, industry trends, and regulatory changes to ensure claims and appeals meet current standards.
What We Do
For over 25 years, Harris Healthcare has been rising to the challenge of bringing together the most innovative and sustainable solutions for today’s ever-changing healthcare environment, in order to improve patient care and safety. Each one of our solutions brings organizational efficiencies on its own. Powerful synergies are achieved when multiple solutions are implemented together. The Harris Healthcare portfolio includes the following solutions:
♦ HARRIS Flex - an enterprise-level EHR solution that improves patient safety and clinical workflows. It includes a full complement of applications integrated in one single database, provides solid clinical decision support to your clinicians and helps standardize care while enforcing protocols and best practices at any Healthcare Organization. HARRIS Flex conveys the digital solution’s flexibility and strength.
Healthcare organizations are continuously faced with new challenges and situations and require flexible EHR’s that can be rapidly adapted to their evolving clinical practice. Contrary to other EHR solutions which are inflexible and where customizations require costly support from the vendor, HARRIS Flex gives you the freedom to "flex" your EHR as you need it entirely on your own.
The enhanced HARRIS Flex solution comes with new functionality including:
♦Flex Telehealth which enables virtual visits directly from within the EHR/EPR, and
♦Flex Clinical Insight which facilitates extraction and analysis of your EHR/EPR data to improve your processes and outcomes.
♦ SynergyCheck – a proactive interface monitoring solution watching over Clinical, Financial and other interfaces 24/7 to ensure data is flowing between systems
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