Accounts Receivable (AR) & Follow-Up Specialist

Overview

A healthcare organization is seeking a Revenue Cycle AR and Follow-Up Specialist to manage the accounts receivable process within the revenue cycle. This role focuses on timely payment collection, resolving claim denials, and maintaining accurate financial records. The specialist will collaborate with insurance companies, patients, and internal departments to optimize revenue collection and ensure compliance with billing regulations.

Responsibilities

• Perform all duties of a Billing Specialist
• Manage complex accounts including follow-up, appeals, and credit balance resolution
• Follow up on unpaid claims and investigate claim denials by reviewing medical records, coding, and payer contracts
• Write and submit escalated appeal letters to overturn denials, adhering to billing and compliance guidelines
• Review daily clearinghouse rejections, resolve issues, and report trends to management
• Maintain detailed and accurate patient financial records with documentation of all actions
• Coordinate with healthcare providers to obtain necessary medical documentation, referrals, or authorizations
• Follow up on multiple payor types across various states, including Commercial, Medicare, Medicaid, Medicaid Managed Care, Blue Cross, Title X, etc.
• Review aged accounts and escalate denial and appeal projects with payors
• Achieve established key performance indicators (KPIs)
• Communicate effectively with insurance companies, patients, and healthcare providers to resolve billing issues
• Assist the Revenue Cycle Manager in resolving issues and supporting the revenue cycle team
• Ensure compliance with organizational policies and all applicable state and federal regulations
• Demonstrate commitment to advancing health equity, particularly racial equity, and accountability to the community
• Provide constructive feedback and accountability related to equity practices

Requirements

• Bachelor's degree in healthcare administration or equivalent experience
• Minimum of 2 years of relevant accounts receivable experience
• Experience with ICD-10 Medical Coding and Current Procedural Terminology (CPT)
• Knowledge of medical terminology
• Strong analytical and problem-solving skills
• Proficiency with Microsoft software, including Excel
• Customer-centric service approach in a fast-paced environment
• Excellent written and verbal communication skills
• Ability to collaborate across all organizational levels and with external stakeholders
• Strong attention to detail and ability to multitask
• Dedication to the organization's mission, vision, and values
• Strong interpersonal skills and relationship-building abilities
• Excellent time management and problem-solving skills

Preferred Qualifications

• Proficiency with Excel, Word, Windows environment
• Experience with Epic, eCW, NextGen, or other practice management systems
• Medical Billing and Coding certification, Certified Revenue Cycle Representative (CRCR), or other relevant certifications
• Willingness to travel as needed, complying with travel policies and safety guidelines

Key Competencies

• Commitment to advancing racial equity and understanding its impact on healthcare
• Awareness of multiple group identities and dynamics with empathy and humility
• Ability to communicate clearly and receive feedback related to identity and equity
• Strong accountability to equitable practices
• Understanding of identity dynamics on organizational culture
• Commitment to workplace values and service standards promoting equity

Compensation & Benefits

• Hourly pay range: $22 - $32, with actual salary based on education, experience, and other factors
• Health care coverage including medical, dental, and vision (eligibility from date of hire for full-time employees)
• Flexible Spending Accounts and Health Savings Account options
• Short-Term Disability and Basic Life & AD&D Insurance provided
• Voluntary Long Term Disability and Additional Life & AD&D Insurance available
• Employee Assistance Program
• Retirement plan with 3% employer match after one year of service
• Paid Time Off program including accrual-based PTO, Health Time Off, and nine paid holidays

Location

Position location details are not specified.

This organization is an equal employment opportunity employer committed to building an inclusive workplace that values racial and social justice. Applicants from all racial and ethnic groups and members of the LGBTQIA+ community are strongly encouraged to apply.

Artificial intelligence tools may be used to assist in parts of the hiring process; however, final hiring decisions are made by humans.