Accounts Receivable Specialist

This is a fully remote position, open to applicants in Arizona, +11 more states.

📋 Description

• Oversee designated insurance accounts receivable to guarantee prompt reimbursement and minimize aging balances.

• Follow up with insurance payers on pending claims, underpayments, denials, and discrepancies in payments.

• Investigate and rectify claim denials by submitting corrected claims, appeals, reconsiderations, and necessary documentation in line with payer specifications.

• Review claim edits and rejections to ensure correct resubmission and reduce future denials.

• Accurately record insurance payments, adjustments, and remittances within the billing system.

• Conduct daily payment reconciliation to ensure that posted payments correspond with electronic remittance advice (ERA), explanation of benefits (EOB), bank deposits, and payment reports.

• Research and resolve unapplied cash, payment variances, overpayments, and underpayments.

• Reconcile payer payments against contracted reimbursement rates and escalate payment discrepancies as necessary.

• Maintain precise documentation of AR activities, payer communications, payment research, and resolution outcomes.

• Professionally and empathetically respond to patient inquiries regarding insurance claims, billing statements, payment activity, balances, and Oshi's billing model, policies, procedures, and applicable healthcare regulations.

• Foster open communication with providers, payers, and internal stakeholders to investigate, resolve, and avert claim and payment issues.

• Collaborate with Billing, Eligibility & Benefits, Credentialing, Finance, Clinical Operations, and other cross-functional teams to address reimbursement issues and enhance revenue cycle performance.

• Analyze accounts receivable, payment, and denial data to identify trends, root causes, and opportunities for process enhancement.

• Monitor and report on AR performance, payment posting accuracy, denial trends, aging, and other essential revenue cycle metrics, providing insights and recommendations to leadership.

• Assist with month-end close activities, payment balancing, reporting, and audit requests.

• Identify recurring reimbursement or operational challenges and propose process improvements to enhance payment accuracy, expedite cash collections, and decrease denials.

• Ensure adherence to organizational policies, payer requirements, financial regulations, HIPAA, and healthcare billing standards while maintaining precision and integrity in all revenue cycle activities.

⛳️ Requirements

• Bachelor's Degree in Business Administration or relevant coursework.

• 2+ years of experience in the healthcare revenue cycle with an emphasis on accounts receivable, payment posting, or insurance billing.

• Familiarity with medical billing, insurance claims processing, and payer reimbursement.

• Proven experience in resolving claim denials, underpayments, and payment discrepancies.

• Experience in posting payments and reconciling ERAs, EOBs, deposits, and unapplied cash.

• Ability to work effectively in a remote environment while managing priorities independently.

• Proficient in EMR and medical billing systems.

• Strong analytical, problem-solving, and organizational skills with an excellent attention to detail.

• Exceptional communication and customer service abilities.

• Proficient in Google Workspace (Sheets, Docs, Gmail) and capable of quickly learning new systems and technologies.

🏝️ Benefits

• Health Benefits: Employer-sponsored medical, dental, and vision coverage

• Time Off: Unlimited PTO + 11 paid company holidays

• Retirement: Eligibility to contribute to 401(k)

• Work Style: Remote-first — work from home within our approved states

• Growth: Tailored professional development opportunities as we scale

• Life Concierge: Access to Overalls, because we know life happens