Accounts Receivable Specialist

About Us:

Forge Health is a mission-driven outpatient mental health and substance use provider dedicated to providing the highest quality, affordable, and effective “one-stop-shop” care to individuals, families, and communities in need. As the first and only behavioral healthcare provider with a proven, national payer-validated ability to drive clinical outcomes that span all areas of health, Forge Health is leading the charge in driving innovation, improving care delivery, and shaping the future of behavioral health care.

For the third consecutive year, were thrilled to share that Forge Health has been recognized on the prestigious Inc. 5000 list of the fastest-growing private companies in America– a remarkable honor that is a testament to our team's relentless commitment to our mission. If you're passionate about building a great business that makes a difference and working alongside sharp, dedicated, and entrepreneurial individuals, then Forge Health is the right fit for you. Come join us!

Who we're looking for:

We are looking for an Accounts Receivable Specialist to join our corporate team. The Accounts Receivable Specialist is a key member of our team and will work directly with insurance carriers (via phone and web portals) for Forge Health’s ten (and growing) facilities across New York, New Jersey, Pennsylvania, New Hampshire and Massachusetts. This position can be performed remotely, and reports into our Director of Revenue Cycle Management.

What you'll be doing:

• Work directly with insurance carriers via phone and web portals to follow up on outstanding claims, resolve payment variances, and achieve timely reimbursement.
• Examine denied claims to determine reasons and correct denials to be reprocessed for payment.
• Write and submit appeals to insurance carriers to resolve denials.
• Works with management to identify, trend, and address root causes of rejects and denials.
• Maintains a thorough understanding of federal and state regulations, as well as specific payer requirements and explanations of benefits, in order to identify and report billing compliance issues and payer discrepancies
• Ensures strict confidentiality of personal client information and data.
• Drafts and edits documents/communications, as needed.
• Assists clinical staff in providing excellent customer service to all clients.
• Any other duties as required by supervisor.

What you'll need:

• 3 years of A/R Follow Up experience
• 2 years of A/R Insurance experience in the healthcare sector preferred.
• Bachelor's degree required.
• Extremely detail-oriented with excellent analytical, problem-solving, and organizational skills
• Ability to keep confidential medical records of patients.
• Works well in groups as well as individually, with minimal supervision.
• Flexible, adaptive, punctual, and highly reliable.