Revenue Integrity AR Specialist

About Us

Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.

Come Join Our Team!

• As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe great work deserves great rewards

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Job Summary

• The Revenue Integrity AR Specialist analyzes payer payment variances across the organization’s three core business units: Radiology, Anesthesia, and Emergency/Hospital Medicine. This role identifies and removes false positives from inventory and resolves underpayments for clients in accordance with each client’s specific payer contracts.

Essential Functions and Tasks

• Identify and resolve contract variances by distinguishing false variances from those requiring action, including collaborating with internal departments, working directly with payers, and reviewing contract language and rates.
• Submit project appeals – preferably in bulk - related to contract performance variances across all specialties.
• Prepare and submit underpayment appeals using established guidelines and accurately document patient accounts in source systems.
• Process and follow up on appeals, including inbound and outbound calls as needed.
• Communicate with insurance companies regarding the status of outstanding appeals.
• Meet established production and quality standards set by Ventra Health.
• Perform special projects and other duties as assigned.

Education and Experience Requirements

• High School Diploma or GED. College education is preferred.
• At least three (3) years of experience in medical billing specifically resolving Accounts Receivable, contacting insurance carriers, using payer portals, completing appeals, identifying and communicating trends.
• Experience with offshore engagement and collaboration desired.

Knowledge, Skills, and Abilities

• Knowledge of State, Federal, and Managed Care regulatory guidelines  
• Knowledge of benefit insurance billing and contract management 
• Strong knowledge of Outlook, Word, Excel (pivot tables), and database software skills.
• Strong oral, written, and interpersonal communication skills 
• Strong decision-making skills 
• Strong problem-solving skills 
• Strong time management skills 
• Basic word processing, spreadsheet, database, and presentation software skills 
• Basic mathematical skills in addition, subtraction, multiplication and division of whole numbers and fractions; computing percentages; and working with decimals 
• Ability to read, understand, and apply state/federal laws, regulations, and policies 
• Ability to exercise sound judgment and handle highly sensitive and confidential information appropriately 
• Ability to remain flexible and work within a collaborative and fast paced environment  
• Ability to communicate with diverse personalities in a tactful, mature, and professional manner
• Become proficient in the use of billing software within 4 weeks and maintain proficiency.
• Understand and comply with company policies and procedures.

Compensation

• Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons. 

• This position is also eligible for a discretionary incentive bonus in accordance with company policies. 

Ventra Health

Equal Employment Opportunity (Applicable only in the US)Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions. Recruitment AgenciesVentra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes. Solicitation of PaymentVentra Health does not solicit payment from our applicants and candidates for consideration or placement.

Attention CandidatesPlease be aware that there have been reports of individuals falsely claiming to represent Ventra Health or one of our affiliated entities Ventra Health Private Limited and Ventra Health Global Services. These scammers may attempt to conduct fake interviews, solicit personal information, and, in some cases, have sent fraudulent offer letters.To protect yourself, verify any communication you receive by contacting us directly through our official channels. If you have any doubts, please contact us at Careers@VentraHealth.com to confirm the legitimacy of the offer and the person who contacted you. All legitimate roles are posted on https://ventrahealth.com/careers/. 

Statement of AccessibilityVentra Health is committed to making our digital experiences accessible to all users, regardless of ability or assistive technology preferences. We continually work to enhance the user experience through ongoing improvements and adherence to accessibility standards. Please review at https://ventrahealth.com/statement-of-accessibility/.