Senior Specialist Accounts Receivable

Overview

A healthcare technology-enabled revenue cycle management organization is seeking a Senior Specialist Accounts Receivable to manage follow-up and denial activities on claims with commercial, governmental, and other payers. The organization provides end-to-end revenue cycle services nationwide to health systems, including hospitals and affiliated physician groups, and has been recognized with multiple "Best in KLAS" awards.

Responsibilities

• Mentor accounts receivable (AR) specialists to enhance skills in denials and appeals
• Analyze denied and unpaid claims to identify reasons for discrepancies
• Resolve complex claims and recommend interventions to management
• Communicate with payers to follow up on claims, file appeals, and resolve payment issues
• Guide team members on complex claims resolution and appeals filing
• Identify causes of underpayments, denials, and payment delays; collaborate on root cause analysis
• Take meeting minutes during payer escalation calls and share key insights with the team
• Maintain knowledge of federal, state, and payer-specific regulations and ensure compliance
• Accurately document all activities in tracking systems
• Monitor escalations within accounts receivable and other revenue cycle areas
• Assist leadership with special projects and DIBS calls as needed
• Meet established productivity and quality standards
• Perform additional duties as assigned

Requirements

• Proficiency in Microsoft Excel and basic computer skills
• Internal candidates: minimum 120% productivity and 98% quality assurance over the past 3 months
• External candidates: must meet quality and productivity standards by day 90 or face demotion
• Strong verbal communication skills
• Problem-solving and critical thinking abilities for account resolution
• Ability to adapt to changing procedures and environment
• Compliance with attendance policies
• Associate’s or bachelor’s degree preferred
• At least 1 year of relevant experience in medical collections, hospital operations, AR follow-up, denials and appeals, compliance, provider relations, or professional billing (preferred)
• Knowledge of claims review and analysis
• Working knowledge of revenue cycle and CRCR certification either upon hire or within 9 months
• Experience with DDE Medicare system and payer websites for claim status investigation
• Familiarity with medical and insurance claim terminology

Compensation & Benefits

• Starting pay: $18.65 per hour; final compensation based on experience
• Bonus incentives
• Paid certifications
• Tuition reimbursement
• Comprehensive benefits
• Career advancement opportunities

Location

This role supports nationwide healthcare systems and may involve remote or onsite work depending on organizational needs.