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.
The organization is an equal opportunity employer committed to diversity and inclusion. All qualified applicants will receive consideration without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.