• Utilize expertise in OB/GYN billing processes to investigate and resolve insurance denials through effective communication with payers and attention to detail in claim resubmissions • Navigate various payer portals to monitor claim status and eligibility and resolve issues promptly • Collaborate with internal teams to gather and provide necessary appeals and claims processing documentation • Maintain up-to-date knowledge of medical billing regulations and compliance requirements • Utilize medical collection practices and procedures to manage outstanding accounts receivable • Ensure accuracy in data entry and record-keeping for billing-related activities • Prioritize tasks effectively to meet deadlines and achieve goals

Job Details PFS Hospital | Remote | Full-time | First Shift Responsibilities & Requirements Responsibilities: - Under the direction of the Patient Accounts Manager or Supervisor the Patient Accounts Representative is responsible for daily billing functions including but not limited to working claim edits, review of insurance claims for accuracy, contacting various parties for further information on unpaid claims, identifying issues resulting in non-payment, and working first level appeals…all incompliance with departmental policies and procedures. - Must display knowledge retention through scheduled competency assessments. - Other duties as assigned. - Essential Skills: - Timely resolution of claim edits allowing timely claim submission - Timely follow-up of unpaid claims, worked to ensure maximum reimbursement following compliant standards - Ability to work independently as well as collaboratively within a team environment - Excellent problem-solving skills Requirements: - High School diploma or equivalent - Experience in Microsoft office tool Preferred Qualifications - Previous experience in patient billing preferred - Epic experience a plus Overview Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it’s by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary This is an Intake position and is a client-facing role, meaning you will support a specific, external client. Intake plays an integral role in delivering cost effective solutions for our patients by working with new patient referrals from an external client; verifying patient health insurance benefits, obtaining initial and subsequent authorization for services if required, loading patient benefit information into client system, calculate pricing and run test claims, and timely communication of benefit information to external client. Important to this position are strong organizational , time management , and critical thinking skills, with the ability to work independently. Ability to meet deadlines, manage future dates for follow up action (e.g. reauthorizations); ability to manage and track forms and other documentation needed by payer and/or requiring physician signature. To be successful in this role you will utilize home infusion software, payer portals and other systems and your critical thinking skills to ensure a high quality of work. Strong verbal, interpersonal, and written communication skills, to effectively communicate with payer staff and external client personnel via telephone and email. Professional and clear documentation of work product entered in client system. Required Qualifications - 1+ years of work experience in revenue cycle operations (eg:intake, billing, collections, credits, cash etc) - 1+ years of experience in a professional environment - 1+ years of experience using the Microsoft Office Suite, specifically Word, Outlook, and Excel Preferred Qualifications - Home infusion or durable medical equipment (DME) experience - Strong attention to detail with a sense of urgency; customer service skills - Ability to work in a team environment Education Verifiable High School Diploma or GED is required. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $17.00 - $28.46 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: - Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. - No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. - Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 04/30/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Overview SummaryThe Orthodontic Accounts Receivable (AR) Specialist is responsible for the timely and accurate execution of insurance claims processing, patient AR follow-up, and resolution of account balances. This position is focused on task-level support for collections, including reviewing EOBs, submitting appeals, correcting billing errors, and contacting payers and patients. The AR Specialist plays a key role in maintaining clean claims, minimizing aging AR, and supporting revenue cycle team goals through dependable daily follow-up activities. Essential Responsibilities• Reads/analyzes Explanations of Benefits (EOBs) for accuracy; determines appropriate follow-up actions. • Submits dental claims, appeals, and supporting documentation to payers. • Identifies and corrects billing errors and resubmits claims as needed. • Conducts root cause research for denied or unpaid claims. • Uses insurance portals and phone outreach to follow up on claim status. • Bills work-in-progress, secondary and tertiary insurance when applicable. • Reviews remittance advice for underpayments or payment discrepancies. • Escalates recurring payer issues or delays to supervisors as needed. • Initiates & maintains patient AR follow-up for overdue balances, per internal protocols. • Coordinates payment arrangements or flag accounts for further collection activity. • Conducts ledger audits, contract corrections, and AR adjustments with policy alignment. • Responds to practice-level inquiries via email or ticketing system in a timely and professional manner. • Supports Cloud9 optimization and contribute feedback to improve workflows. • Meets assigned productivity benchmarks and team performance goals. • Expected to work all scheduled days and hours, and to report to work on time.• Embraces NADG’s values, culture, and “Core 3”: People First, Access to Care, and Cost Containment.• Supports the NADG Care Cycle and prioritizes delivering best-in-class patient care.• Other duties as assigned. Experience/Requirements• Minimum of 2 years in dental revenue cycle, including claims billing and patient collections.• Proficiency in Microsoft Office Suite.• Familiarity with insurance portals and eligibility/claim inquiry tools.• Knowledge of insurance payer guidelines and AR workflows.• Experience with Cloud 9 or other orthodontic software preferred.Knowledge, Skills, and Abilities (KSAs)• Attendance & Reliability: Arrives to work on time; dependable, punctual, and demonstrates strong time management skills. • Cooperation & Teamwork: Works respectfully and effectively with colleagues; contributes meaningfully to help the practice achieve its goals.• Communication Skills: Demonstrates clear, organized, and effective written and oral communication; exhibits strong listening and comprehension abilities.• Customer Service: Provides professional, helpful, and high-quality service to both internal and external customers, addressing patient needs effectively.• Leadership & Decision-Making: Makes thoughtful, well-reasoned decisions; demonstrates resourcefulness and creativity in problem-solving.• Initiative & Flexibility: Takes initiative by seeking additional responsibilities; identifies problems and proposes solutions; adapts well to new challenges and unexpected changes.• Knowledge & Expertise: Possesses a strong understanding of the information, processes, and procedures necessary to perform the role effectively.• Technical Capabilities: Performs job responsibilities with attention to detail, consistency, productivity, and efficiency, in alignment with company and industry standards.• Digital Dentistry: Demonstrates knowledge of digital equipment and software used in the practice, including Open Dental, Primescan, Overjet, and others. Education/Certifications• High school diploma or equivalent• Additional education or certifications in billing/coding preferred. Physical/Environmental• This is a sedentary role, requiring prolonged periods of sitting and regular use of a computer and other standard office equipment.• Requires frequent talking, hearing, and visual acuity for computer work and communication.• May occasionally be required to lift items weighing up to 30 pounds.• Work is performed in a private home office environment.• Occasional travel may be required. #NADG3