Overview
This entry-level Accounts Receivable Specialist position involves managing follow-up with commercial, governmental, and other payers to resolve claim payment issues and secure timely reimbursement. The role includes analyzing denials, payment variances, and no-response claims, drafting and submitting technical and clinical appeals, and supporting denial, no-response, and audit activities.
Responsibilities
- Examine denied and unpaid claims to determine reasons for discrepancies.
- Communicate directly with payers to follow up on outstanding claims, file appeals, resolve payment variances, and ensure accurate reimbursement.
- Identify reasons for underpayments, denials, and payment delays; collaborate with management to identify trends and address root causes.
- Maintain thorough knowledge of federal and state regulations and payer-specific requirements, taking appropriate action.
- Accurately document all activities including contact information and relevant details in client systems.
- Demonstrate initiative by recommending improvements and communicating trends and issues to management.
- Apply problem-solving and critical thinking skills to resolve accounts.
Requirements
- Basic computer proficiency with demonstrated skills in Microsoft Excel.
- Excellent verbal communication skills.
- Strong problem-solving and critical thinking abilities.
- Adaptability to changing procedures and a growing environment.
- Ability to meet quality, productivity, and attendance standards.
- Openness to innovation, including the use of AI to improve processes and experiences.
- Willingness and ability to travel and work onsite at client, temporary, or corporate office locations as needed.
Preferred Qualifications
- Associate or bachelor's degree.
- One or more years of relevant experience in medical collections, physician/hospital operations, AR follow-up, denials and appeals, compliance, provider relations, or professional billing.
- Knowledge of claims review and analysis.
- Working knowledge of revenue cycle management.
- Experience with the DDE Medicare system and payer websites for claim status investigation.
- Familiarity with medical terminology and insurance claim terminology.
Compensation & Benefits
- Hourly pay range: $16.50 - $18.65, based on experience.
- Bonus incentives.
- Paid certifications.
- Tuition reimbursement.
- Comprehensive benefits package supporting physical, emotional, and financial health, including healthcare, time off, retirement, and well-being programs.
- Career advancement opportunities.
Location
- This is a remote position with required travel to client, temporary, or corporate office locations as business needs dictate.
Equal Opportunity
The employer is an equal opportunity organization and does not discriminate based on race, color, sex, sexual orientation, gender identity, religion, national origin, age, disability, military or veteran status, genetic information, or any other protected category. Reasonable accommodations are provided to qualified individuals with disabilities in accordance with applicable laws.