Accounts Receivable (Third Party RCM)

Accounts Receivable Payor Analyst

The Kestra team has over 400 years of experience in the external and internal cardiac medical device markets. The company was founded in 2014 by industry leaders inspired by the opportunity to unite modern wearable technologies with proven device therapies. Kestra's solutions combine high quality and technical performance with a wearable design that provides the greatest regard for patient comfort and dignity. Innovating versatile new ways to deliver care, Kestra is helping patients and their care teams harmoniously monitor, manage, and protect life.

The Accounts Receivable (AR) Payor Analyst plays a critical role in the healthcare revenue cycle by serving as a liaison between the organization and third-party payors. This position is responsible for proactively managing outstanding receivables, resolving payor-related issues, and ensuring timely and accurate reimbursement for healthcare services. This role will serve as the Subject Matter Expert (SME) in Third-Party Accounts Receivable (AR) Collections and is responsible for optimizing the collection of outstanding balances from third-party payors.

This role provides expert-level guidance, analysis, and support to AR teams, ensuring compliance with payor requirements and maximizing reimbursement. The SME serves as a key resource for resolving complex payor issues, improving workflows, and training staff on best practices.

Essential Duties :

• Monitor and manage assigned payor accounts to ensure timely follow-up and resolution of outstanding claims.
• Analyze payor trends and denial patterns to identify root causes and recommend process improvements.
• Communicate effectively with insurance companies to resolve claim issues, including denials, underpayments, and rejections.
• Coordinate capably with outsourcing partners to streamline processes, enhance efficiency, maintain compliance, ensure quality control, cost-effectiveness, and timely delivery of services.
• Monitor payor responses and response timelines for adherence to contractual parameters.
• Collaborate with internal departments such as coding, billing, and patient access to ensure claims are submitted accurately and compliantly.
• Escalate unresolved payor issues to leadership with appropriate documentation and recommendations.
• Maintain detailed documentation of all payor interactions and claim resolution activities in the AR system.
• Maintain current knowledge of payor policies, contract terms, and regulatory changes affecting reimbursement.
• Participate in payor meetings and contribute to contract negotiations by providing data-driven insights.
• Meet or exceed performance metrics related to AR aging, denial resolution, and cash collections.
• Serve as the primary expert on third-party payor collection processes, policies, and regulatory requirements.
• Develop and implement strategies to reduce AR aging and improve collection rates from commercial, government, and managed care payors.
• Lead initiatives to streamline workflows, enhance system functionality, and improve staff productivity.
• Provide training, coaching, and mentorship to AR staff on payor-specific collection techniques and denial resolution.
• Act as a liaison with payor representatives to resolve escalated issues and advocate for timely reimbursement.

Adhere to Pledge of Confidentiality :

Competencies :