Accounts Receivable Specialist

Caris Life Sciences Accounts Receivable Specialist

At Caris, we understand that cancer is an ugly worda word no one wants to hear, but one that connects us all. That's why we're not just transforming cancer carewe're changing lives.

We introduced precision medicine to the world and built an industry around the idea that every patient deserves answers as unique as their DNA. Backed by cutting-edge molecular science and AI, we ask ourselves every day: "What would I do if this patient were my mom?" That question drives everything we do.

But our mission doesn't stop with cancer. We're pushing the frontiers of medicine and leading a revolution in healthcaredriven by innovation, compassion, and purpose.

Join us in our mission to improve the human condition across multiple diseases. If you're passionate about meaningful work and want to be part of something bigger than yourself, Caris is where your impact begins.

Position Summary

The Accounts Receivable Specialist is responsible for reviewing and resolving outstanding denied claims with Medicare, Medicaid and Commercial insurance companies. This included following up on claims statuses, researching rejections and denials, handling medical records request and submitting appeals within the timely filing.

Job Responsibilities

• Review insurance denials and take appropriate action.
• Check claims status via phone or portal.
• Submit Medical Records upon request and follow up on submission.
• Submit HCFA's claims to insurance companies that do not accept electronic claims.
• Submit Retros authorization
• Work closely with insurance companies to resolve claims disputes.
• Identifying and resolving billing errors and implementing processes to prevent future issues.
• Identifying and communicating process improvements to optimize revenue cycle management.
• Utilize payor portals to gather claims status information.
• Respond promptly and professionally to inquiries from insurance companies, patient, and client's representative with good customer service.
• Ensure billing practices comply with HIPAA, CMS guidelines and payor specific policies
• Communicate with insurance companies daily.
• Must meet or exceed production and quality standards.
• Review insurance rejections and make necessary corrections
• Prepare and submit appeals with supporting documentation within timely filing.
• Submit corrected claims to insurance companies.

Required Qualifications

• High School diploma or equivalent required.
• 2-4 years of experience in a related industry
• Strong understanding of Explanation of Benefits (EOBs) to determine denial reasons and appropriate actions.
• Excellent communication and interpersonal skills.
• Ability to work independently and as part of a team.
• Attention to detail and strong organizational skills.
• Strong experience using computer software, including medical billing software.
• Proficient in Microsoft Office Suite, specifically Word, Excel, Outlook, and general working knowledge of Internet for business use.
• Strong Problem-Solving skills with attention to detail.
• Strong knowledge of CPT, ICD-10
• Ability to adapt to frequent changes and manage tasks efficiently

Preferred Qualifications

• Associate's degree accounting, finance, healthcare administration, or a related field OR equivalent combination of education and experience
• 2+ year's experience in a Medical billing related position, with experience in AR
• Must possess professionalism, superior organizational skills, communications skills that allow the ability to educate and influence, an unrelenting passion for persistent follow up, and a drive towards problem resolution.
• Overall responsibility will be to follow-up on all claims from billing through final resolution and reduce delinquent accounts to achieve maximum collections from all sources.
• Drive for Results (Service, Quality, and Continuous Improvement) - Ensure procedures and processes are in place that will lead to delivery of quality results and continually reassess their effectiveness to achieve continuous improvement.
• Communication - Proficient verbal and written communication skills. Willingness to share and receive information and ideas from all levels of the organization to achieve the desired results.
• Teamwork - Commitment to the successful achievement of team and organizational goals through a desire to participate with and help other members of the team.
• Customer Service Focus - Demonstrate a focus on listening to and understanding client/customer needs and then delighting the client/customer by exceeding service and quality expectations.

Physical Demands

• Must possess ability to sit and/or stand for long periods of time.
• Must possess ability to perform repetitive motion.
• Ability to lift up to 15 pounds.
• The majority of work is performed in a desk/cubicle environment.

Training

• All job specific, safety, and compliance training are assigned based on the job functions associated with this employee.

Other

• Willingness to work shift work and overtime.
• Job may require occasional weekends, evenings, and/or holidays.

Conditions of Employment: Individual must successfully complete pre-employment process, which includes criminal background check, drug screening, credit check (applicable for certain positions) and reference verification.

This job description reflects management's assignment of essential functions. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time.

Caris Life Sciences is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.