Senior Accounts Receivable Specialist

Overview

A leading provider of technology-enabled revenue cycle management solutions for health systems is seeking a Senior Specialist, Accounts Receivable. This role involves managing follow-up and denial activities related to commercial, governmental, and other payers to resolve claim payment issues and secure timely reimbursement. The position includes mentoring team members, identifying trends in denied payments, and assisting leadership with projects aimed at accounts receivable reduction and cash acceleration.

Responsibilities

• Mentor Accounts Receivable (AR) Specialist team members to enhance skills in follow-up, denials, and appeals processes.
• Examine denied and unpaid claims to determine reasons for discrepancies.
• Resolve complex claims proactively and recommend interventions based on identified trends.
• Communicate directly with payers to follow up on outstanding claims, file technical and clinical appeals, and resolve payment variances.
• Provide guidance to team members on complex claims and appeals.
• Identify reasons for underpayments, denials, and payment delays; collaborate with management to address root causes.
• Take meeting minutes during payer escalation calls and share key takeaways with AR associates.
• Maintain thorough knowledge of federal and state regulations and payer-specific requirements, ensuring compliant billing.
• Accurately document all activities, including contact information and pertinent details, in client systems.
• Review escalations from other revenue cycle areas and assist supervisors with special calls as needed.
• Meet established productivity and quality standards.
• Perform additional duties and projects as assigned.

Requirements

• High School Diploma, GED, or equivalent experience.
• 1 to 3 years of relevant experience.
• Certification such as CRCR required upon hire or within 9 months (or other approved job-relevant certification).
• Basic computer skills with proficiency in Microsoft Excel.
• Strong verbal communication, problem-solving, and critical thinking skills.
• Ability to adapt to changing procedures and a growing environment.
• Must meet productivity and quality standards within specified timelines.
• Willingness and ability to travel to client, temporary, or corporate office locations as needed.
• Internal candidates must have met 120% productivity and 98% quality assurance in the previous 3 months.
• External candidates must meet quality and productivity standards by day 90; failure results in demotion with eligibility to reapply after 90 days.

Preferred Qualifications

• Associate or bachelor's degree.
• 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 DDE Medicare system and payer websites for claim status investigation.
• Familiarity with medical and insurance claim terminology.
• Openness to innovation, including AI, to improve processes and client experiences.

Compensation & Benefits

• Hourly pay range: $18.65 - $20.50 based on experience.
• Bonus incentives.
• Paid certifications.
• Tuition reimbursement.
• Comprehensive benefits package supporting physical, emotional, and financial health.
• Career advancement opportunities.

Location

• This is a remote position with required travel to client, temporary, or corporate office locations as business needs dictate.