This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. 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.

• Prepare, validate, and submit client invoices accurately and on time according to contract terms and client-specific requirements. • Reconcile timekeeping, expense, and payroll data to confirm accuracy prior to billing. • Track and manage purchase orders (POs), cost codes, and work orders to ensure proper funding and approval alignment. • Submit and monitor invoices through client and third-party systems (OpenInvoice, Ariba, Cortex, Fieldglass, or other VMS tools). • Audit and maintain complete supporting documentation including jobsheets, client approvals, and project references. • Collaborate with Payments, Payroll, and Accounting teams to resolve discrepancies and ensure data integrity prior to revenue recognition and invoice submission. • Track submission progress and contribute to month-end reporting. • Manage accounts receivable aging for assigned portfolios to ensure prompt payment and minimal delinquency. • Conduct consistent outreach to client contacts and intermediaries to confirm invoice receipt, resolve disputes, and secure payment commitments. • Log all communications, payment activity, and resolution updates within collections software for visibility and continuity. • Partner with Sales, Account Management, and Operations to address recurring issues, coordinate on approvals, and enhance customer experience. • Work with Managed Service Providers (MSPs) and vendor management intermediaries to ensure compliance with payment and approval processes. • Support reconciliation of unapplied cash and assist Accounting during monthly close to ensure accuracy in financial reporting. • Monitor client trends, flag potential risks, and communicate delays or anomalies to leadership for resolution. • Collaborate with Sales, Account Management, and Customer Support teams to align on client status, open issues, and strategic account priorities. • Partner with broader Financial Operations functions (Payroll, Payments, Invoicing, Cash, Credit, and Collections) to resolve complex account reconciliations or delinquent balances. • Participate in audits and process reviews, ensuring documentation and reporting meet internal and client standards. • Coordinate with Data, Systems, and Engineering teams to enhance process automation, reporting accuracy, and system integration. • Identify and communicate recurring process challenges; propose improvements and support implementation of new workflows or documentation updates. • Contribute to team meetings, training sessions, and cross-functional initiatives that strengthen collaboration and operational consistency.

• Review denied claims based on assigned markets, payers and work queues within our practice management system • Accurately and efficiently processes requests for denied claims information using website portals and outbound phone calls for all Commercial, Medicare and Medicaid insurance payers • Researches and responds to documentation requests from insurance carriers in a timely manner • Processes appeals of insurance denials and follows-up until the appeal is resolved • Obtains, reviews and updates patient demographics and insurance information within both EHR and practice management billing system as needed • Complete timely follow-up on claims submitted to payer, but no response or ERA after 45 days to resolve any pending issues with claim and payer within timely filing limits • Documents clear and concise activities performed in the system for each account worked • Adheres to all HIPAA (Health Insurance Accountability and Portability Act) guidelines and regulations • Ability to consistently maintain productivity and quality expectations as defined by the leadership team • Alert management to irregularities, insurance trends and areas of concern with reimbursement • Completes other tasks and projects as assigned by RCM Leadership

• Denial Review and Resolution: Review and resolve denied insurance claims by contacting insurance carriers, researching denial reasons, and ensuring accurate billing and coding practices. • Documentation and Appeal: Compile necessary documentation to support insurance appeals and collaborate with other departments to address editing, coding, and payment issues. • Trend Analysis: Identify denial trends and work with billing and coding teams to implement process changes to prevent future denials. • Follow-up and Communication: Maintain communication with insurance companies and patients to ensure accurate and timely payment. • Compliance: Stay abreast of current insurance regulations and managed care contractual obligations. • Customer Service: May assist with patient phone calls and customer service inquiries. • Reporting: May be responsible for generating reports on denial trends and other relevant metrics. • Cash Reconciliation/Payment Posting: Review and post electronic and manual payments from insurance carriers and patients, Perform reconciliation of bank deposits to posted payments.