The Johns Hopkins University
AR Revenue Cycle Specialist (Pathology) - 119229
The Johns Hopkins University, Middle River, Maryland, United States, 21220
AR Revenue Cycle Specialist (Pathology) - 119229
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Requisition ID: 119229 Pathology Department is seeking an AR Revenue Cycle Specialist responsible for the basic collection of unpaid third‑party claims and standard appeals, using various JHM and JHU/PBS billing applications. The specialist communicates with payers to resolve issues and facilitate prompt payment of claims. Responsibilities include follow‑up with insurance companies, recognizing and resolving incorrect demographic and insurance registration, expediting payments, and managing appeals and rejections.
Specific Duties and Responsibilities
Use A/R follow‑up systems and reports to identify unpaid claims for collection or appeal.
Gather and verify all information required to produce a clean claim, including special billing procedures defined by a payer or contract.
Review and update patient registration information (demographic and insurance) as needed.
Resolve claim edits and apply appropriate discounts or courtesies based on department policy.
Prepare delinquent accounts for transfer to the self‑pay collection unit according to the follow‑up matrix.
Print and mail claim forms and statements according to the follow‑up matrix.
Retrieve supporting documents (medical reports, authorizations, etc.) and submit to third‑party payers.
Appeal rejected claims and claims with low reimbursement.
Perform claim edits and confirm credit balances, gathering necessary documentation for processing refunds.
Identify insurance issues of primary vs. secondary insurance and coordination of benefits eligibility causing non‑payment of claims.
Contact payors or patients as appropriate for corrective action to resolve the issue and receive payment of claims.
Monitor invoice activity until the problem is resolved.
Process daily mail, edits, reports, file or pull EOB batches.
Identify and escalates non‑standard appeals to a higher‑level specialist.
Inform the supervisor/Production Unit Manager of issues or problems associated with non‑payment of claims.
Minimum Qualifications
High School Diploma or graduation equivalent.
One year experience in medical billing, insurance follow‑up processing, or similar medical specialty environment.
Additional education may substitute for required experience, and additional related experience may substitute for required education beyond a high school diploma/graduation equivalent, to the extent permitted by the JHU equivalency formula.
Position Details
Job Title: AR Revenue Cycle Specialist (Pathology)
Classification: ATO 40/E/02/OC
Salary Range: $15.70 – $25.25 per hour ($38,000 targeted; commensurate with experience).
Employment Status: Full Time (Non‑Exempt FLSA).
Schedule: Monday‑Friday, 8:30 am – 5 pm.
Location: Remote.
Department: SOM Pat Production Unit Billing, School of Medicine, Johns Hopkins University.
Employee Group: Full Time.
Seniority Level Entry level
Employment Type Full‑time
Job Function Accounting/Auditing and Finance
Industries Higher Education
Equal Opportunity Employer All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
EEO is the Law. https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf
#J-18808-Ljbffr
Requisition ID: 119229 Pathology Department is seeking an AR Revenue Cycle Specialist responsible for the basic collection of unpaid third‑party claims and standard appeals, using various JHM and JHU/PBS billing applications. The specialist communicates with payers to resolve issues and facilitate prompt payment of claims. Responsibilities include follow‑up with insurance companies, recognizing and resolving incorrect demographic and insurance registration, expediting payments, and managing appeals and rejections.
Specific Duties and Responsibilities
Use A/R follow‑up systems and reports to identify unpaid claims for collection or appeal.
Gather and verify all information required to produce a clean claim, including special billing procedures defined by a payer or contract.
Review and update patient registration information (demographic and insurance) as needed.
Resolve claim edits and apply appropriate discounts or courtesies based on department policy.
Prepare delinquent accounts for transfer to the self‑pay collection unit according to the follow‑up matrix.
Print and mail claim forms and statements according to the follow‑up matrix.
Retrieve supporting documents (medical reports, authorizations, etc.) and submit to third‑party payers.
Appeal rejected claims and claims with low reimbursement.
Perform claim edits and confirm credit balances, gathering necessary documentation for processing refunds.
Identify insurance issues of primary vs. secondary insurance and coordination of benefits eligibility causing non‑payment of claims.
Contact payors or patients as appropriate for corrective action to resolve the issue and receive payment of claims.
Monitor invoice activity until the problem is resolved.
Process daily mail, edits, reports, file or pull EOB batches.
Identify and escalates non‑standard appeals to a higher‑level specialist.
Inform the supervisor/Production Unit Manager of issues or problems associated with non‑payment of claims.
Minimum Qualifications
High School Diploma or graduation equivalent.
One year experience in medical billing, insurance follow‑up processing, or similar medical specialty environment.
Additional education may substitute for required experience, and additional related experience may substitute for required education beyond a high school diploma/graduation equivalent, to the extent permitted by the JHU equivalency formula.
Position Details
Job Title: AR Revenue Cycle Specialist (Pathology)
Classification: ATO 40/E/02/OC
Salary Range: $15.70 – $25.25 per hour ($38,000 targeted; commensurate with experience).
Employment Status: Full Time (Non‑Exempt FLSA).
Schedule: Monday‑Friday, 8:30 am – 5 pm.
Location: Remote.
Department: SOM Pat Production Unit Billing, School of Medicine, Johns Hopkins University.
Employee Group: Full Time.
Seniority Level Entry level
Employment Type Full‑time
Job Function Accounting/Auditing and Finance
Industries Higher Education
Equal Opportunity Employer All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
EEO is the Law. https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf
#J-18808-Ljbffr