Overview
This entry-level Accounts Receivable Specialist position involves following up directly with commercial, governmental, and other payers to resolve claim payment issues and secure appropriate and timely reimbursement. The role includes identifying and 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 non-paid claims to determine reasons for discrepancies.
- Communicate directly with payers to follow up on outstanding claims, file technical and clinical appeals, resolve payment variances, and ensure timely and accurate reimbursement.
- Identify specific reasons for underpayments, denials, and payment delays; collaborate with management to identify, trend, and address root causes in accounts receivable.
- Maintain thorough understanding of federal and state regulations and payer-specific requirements, taking appropriate action accordingly.
- Accurately document all activities including contact information in client systems or tracking tools.
- Demonstrate initiative by making recommendations and communicating trends and issues to management.
- Apply strong problem-solving and critical thinking skills to resolve accounts.
Requirements
- Basic computer knowledge with proficiency in Microsoft Excel.
- Excellent verbal communication skills.
- Strong problem-solving and critical thinking abilities to develop collection plans and apply payment tools effectively.
- 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 client experiences.
- This is a remote position; candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.
Preferred Qualifications
- Associate or bachelor's degree.
- One or more years of relevant experience in medical collections, physician/hospital operations, accounts receivable 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 using payer websites to investigate claim statuses.
- 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
Remote position with required willingness to travel to client, temporary, or corporate office locations as needed.
The employer is an equal opportunity employer and provides reasonable accommodations to qualified individuals with disabilities in accordance with applicable laws.