Accounts Receivable Representative

This is a fully remote position, open to applicants in Florida, +6 more states.

📋 Description

• Conduct regular follow-ups on pending insurance claims.

• Manage assigned accounts receivable and payer worklists in accordance with RCM priorities and aging protocols.

• Investigate unpaid, underpaid, rejected, and denied claims to determine appropriate resolutions.

• Communicate with insurance payers via portals, phone, and other available resources.

• Analyze claim statuses, remittance details, EOBs, and ERAs.

• Correct claim inaccuracies and resubmit amended claims, reconsiderations, and appeals.

• Address eligibility, authorization, coding, billing, timely filing, coordination of benefits, medical necessity, and payer-specific issues.

• Follow up on denied claims to secure payment or a final resolution.

• Detect underpayments and reimbursement discrepancies, escalating payer or contractual issues as necessary.

• Keep thorough account documentation and records of payer communications.

• Prioritize accounts based on aging, balances, deadlines, and departmental needs.

• Identify payer trends, denial patterns, workflow challenges, and reimbursement obstacles; report findings to RCM leadership.

• Collaborate with coding, intake, clinical operations, and internal teams.

• Support objectives related to Days in AR, Net Collection Rate, denial rates, timely filing, and AR reduction.

• Adhere to HIPAA and payer/regulatory compliance standards.

• Assist with AR projects, account maintenance, payer research, and other revenue cycle tasks.

• Perform additional RCM responsibilities as assigned.

⛳️ Requirements

• 3–5 years of experience in healthcare accounts receivable, insurance claim follow-up, and claim resolution.

• Proven ability to independently research and resolve unpaid, underpaid, rejected, and denied insurance claims.

• Comprehensive understanding of the healthcare revenue cycle and insurance reimbursement processes.

• Experience working with both commercial and government payers.

• Capability to interpret EOBs, ERAs, claim status updates, denial messages, and payer communications.

• Proficiency in utilizing payer portals and engaging directly with insurance companies to resolve claims.

• Exceptional attention to detail and strong organizational skills.

• Ability to handle a high-volume AR workload effectively.

• Skill in identifying trends and escalating systemic reimbursement or payer-related issues.

• Excellent written and verbal communication abilities.

• Capacity to work independently while also collaborating within an RCM team environment.

• Residency in Florida, Georgia, North Carolina, New York, Ohio, Pennsylvania, Tennessee, or Texas is required.

• Preferred: experience in behavioral health and/or substance use disorder billing and AR.

• Preferred: familiarity with Medicaid, managed Medicaid, Medicare, and commercial insurance claims.

• Preferred: experience with athenahealth.

• Preferred: knowledge of Availity and other payer portals.

• Preferred: background in a multi-state healthcare organization.

• Preferred: experience with denial management, appeals, corrected claims, and complex claim resolution.

• Ability to sit at a desk and work on a computer for extended periods.

• Must be capable of lifting and carrying up to 15 pounds occasionally.

• Competence in safely operating standard office equipment.

• Clear and effective communication skills, both verbally and in writing.

🏝️ Benefits

• Comprehensive medical, dental, and vision insurance for you and your family.

• 401(k) matching contributions up to 5%.

• 100% employer-paid short-term and long-term disability insurance.

• Employer-sponsored life insurance coverage.

• Generous paid time off, floating holidays, and paid volunteer days.

• Four paid Re-Fuel Days each year for mental health, rest, or continuing education.

• Employee Assistance Program offering therapy sessions, legal advice, financial resources, and health coaching.

• SoFi student loan interest rate discount.

• Rightway Health Concierge service.

• One year of complimentary pet Telehealth through Pawp.

• Access to the Perkspot Discount Marketplace.

• A supportive and collaborative workplace culture.