Advantia Health

Role Description The RCM Accounts Receivable (AR) Manager is responsible for establishing billing and collection performance goals, designing and implementing effective collection strategies, and leading a team of collectors and patient support staff to meet or exceed organizational objectives. This role requires strong skills in negotiating and resolving conflicts, with a keen eye for detail and a commitment to adhering to company policies and legal regulations. - Lead and manage end-to-end revenue cycle operations, including daily productivity and staff assignments. - Develop strategic initiatives and performance metrics. - Collaborate with executive leadership and cross-functional teams. - Integrate technology and data-driven decision-making. - Ensure compliance with HIPAA, CMS, and payer regulations. - Implement policies and training for accurate coding and billing. - Hire, train, and mentor revenue cycle staff. - Serve as a liaison with providers, insurers, and vendors. - Provide timely reporting and analysis to leadership. - Support forecasting and business planning. - Maintain up-to-date knowledge of industry trends and regulations. - Address patient complaints and ensure satisfaction. - Uphold clinic policies and safety standards. Qualifications - Knowledge of billing procedures and payer policies - Proficient in Excel and other MS Office products - Excellent communication and interpersonal skills - Ability to handle sensitive, confidential information Requirements - 2+ years of Athena experience and/or super user - 5-7 years' experience within Revenue Cycle Management - Strong knowledge of front-end processes - Strong knowledge of back-end processes including billing, follow-up, denials, and customer service - In-depth working knowledge of all payer rules and policies - Effective communication, presentation, and project management skills - Excellent oral and written communication - Proficient experience in computer technology, including Microsoft Word, PowerPoint, and Excel - Strong training and evaluative skills Benefits - Health, Dental, and Vision Insurance - Health Savings Account (HSA) and Flexible Savings Account (FSA) Option - 401k Retirement Plan - Life and Disability Insurances - Paid holidays/PTO

Advantia is seeking a Claims Resolution Specialist specializing in Lab Billing to join our team! As a Claims Resolution Specialist (Lab Billing), you will be essential in ensuring the accuracy and timeliness of billing and reimbursement for medical services. This important role demands a solid understanding of medical terminology, coding, and billing procedures. This role will report to the RCM Manager. Job Responsibilities: - Initiating ERA (electronic remittance advice) set up with clearinghouse and/or third-party portals. - Initiating EFT (electronic funds transfer) set up with payers & third-party portals. - Assist in vendor support of daily cash reconciliation duties. - Clear understanding of RCM Payment Posting Processing (ERA/Manual Posting) of Line-Item Payments/Denials. - Clear understanding of reconciling offset/recoupment payer remits. - Call carriers and third parties to resolve unidentified payments/reconcile items. - Responsible for maintaining payer portal admin and employee registration. - Assist the RCM Manager with various projects. Job Requirements: - High School/GED Education required - Previous experience in medical billing or a related field is preferred. - Proficiency in electronic health records and billing software preferred. - Athena experience required. Benefits & Compensation: - Health, Dental, and Vision Insurance - Health Savings Account (HSA) and Flexible Savings Account (FSA) Option - 401k Retirement Plan - Life and Disability Insurances - Paid holidays/PTO Please note: Advantia Health provides unparalleled healthcare to our customers by employing the most highly qualified individuals. If you are selected for further consideration, you will be subject to a background investigation. COVID-19 and Flu vaccination or an approved request for accommodation is required as a condition of employment. Advantia Health is an Equal Opportunity Employer that is committed to global diversity: It is a place where good people want to work, and customers want to continue to engage EOE M/F/D/V.

• Review Medical Records to identify diagnoses/procedures. • Perform accurate and timely coding of medical records using ICD-10-CM, CPT, and HCPCS codes. • Ensure compliance with federal and state regulations, payer guidelines, including Medicare and Medicaid guidelines and company policies. • Act as a liaison between the coding team and other departments, such as billing, compliance. • Work closely with OBGYN physicians, advanced practice providers, nurses, and administrative staff to ensure accurate coding and billing. • Track and request outstanding claims for assigned departments / facilities. • Implement best practices and innovative solutions to enhance coding operations.