Overview
A healthcare organization is seeking a full-time Accounts Receivable Specialist to join their Revenue Cycle team. This remote role focuses on insurance follow-up, denial resolution, appeals, and collections related to open accounts receivable. The ideal candidate will have experience working with insurance denials, identifying denial trends, analyzing Explanation of Benefits (EOBs) and remittance advices, and communicating directly with commercial and government payers to maximize reimbursement. Familiarity with coding-related denial issues and collaboration with coding resources is also important.
Pay: $19-23 per hour, depending on experience
Schedule: Monday - Friday, 8:00 AM - 4:30 PM
Location: Remote position requiring residency in one of the following states: PA, MD, VA, NC, TN, GA, FL. Applicants outside these states will not be considered.
Responsibilities
- Conduct insurance follow-up and collections activities, including telephone calls and accessing payer websites
- Identify root causes of denials, categorize denial reasons, and coordinate with clinics or management to implement process improvements
- Manage performance and ensure timely communication regarding reimbursement issues
- Resolve complex or aged accounts receivable, including payment research and recoupment, with minimal assistance
- Review account information and system applications to determine appropriate next steps
- Verify claims adjudication using relevant resources and applications
- Edit claims to comply with billing guidelines for electronic submission
- Manage individual work lists and inventories, complete reports, and resolve high priority and aged accounts
- Stay informed about changes in procedures and laws related to specific insurance carriers or payers
- Communicate issues to management and develop solutions for payer, system, or escalated account problems
- Perform other duties as assigned by management
Qualifications
- Minimum of 3 years of experience in healthcare accounts receivable or revenue cycle
- Experience identifying and resolving insurance denials, including eligibility, authorization, medical necessity, and coding-related denials
- Ability to manage an individual work queue while meeting productivity and quality standards
- Knowledge of common denial trends, including modifier-related denials (e.g., Modifier 25, 59, RT/LT) and payer-specific billing requirements
- Strong understanding of insurance denials, appeals, and claims follow-up processes
- Experience working with both government and commercial payers
- Ability to analyze EOBs, remits, and claim details to determine appropriate next steps
- Comfortable working independently in a remote environment while managing productivity expectations
- Strong attention to detail and organizational skills
- Effective written and verbal communication skills
Education
- High school diploma or equivalent required
Benefits (for employees working 30+ hours per week)
- Medical, dental, and vision insurance (effective the first of the month following start date)
- Short-term and long-term disability insurance
- Voluntary life, critical illness, and hospital indemnity coverage
- Company-paid basic life and AD&D insurance
- Paid time off and paid holidays
- Retirement savings plan
- Employee discounts on cosmetic services and products