Accounts Receivable Specialist

This is a fully remote position, open to applicants in South Carolina.

📋 Description

• Timely and accurately manage unpaid claims within EMR systems.

• Follow up with payors on outstanding balances to secure prompt and precise payments.

• Correct and resubmit claims through EMR systems and/or clearinghouses as necessary.

• Submit timely, valid, and well-documented adjustments with the approval of management.

• Investigate unpaid claims via payor phone calls, web portals, and established guidelines.

• Keep clear, concise, and current documentation of account statuses.

• Communicate and document any issues identified during claim follow-up.

• Recognize billing issues, including codes and modifiers, and relay them to the appropriate personnel.

• Maintain daily productivity standards.

• Report daily key performance indicators using reporting tools.

• Assist in training and mentoring team members.

• Support project work and undertake other assigned responsibilities.

• Self-report at the conclusion of each business day.

• Facilitate productivity verification using User Performance reporting in Waystar (OTP) and analysts’ spreadsheets.

⛳️ Requirements

• A minimum of 3 years of accounts receivable experience in a physician office environment is required.

• General understanding of HCPCS, CPT-4, and ICD-10 coding and/or medical terminology.

• Familiarity with various payer requirements, including Medicaid, Medicare, and/or commercial insurance follow-up, as well as regulations for claims processing.

• Experience in researching and analyzing unpaid and denied claims, including communication with payors, resubmissions, and appeals.

• A High School Diploma or GED is mandatory.

• Required work schedule is Monday through Friday from 9:00 AM to 5:00 PM.

• Preference for candidates in the EST time zone.

• Minimum productivity of 50 claims processed per day.

• Understanding and compliance with state and federal regulations, as well as system policies pertaining to compliance, HIPAA, integrity, and ethical billing practices.

🏝️ Benefits

• Comprehensive training provided for newcomers to this field.

• Mileage reimbursement (if applicable) with Crossroads matching the current IRS mileage reimbursement rate.

• Engagement in community events that foster belonging and education, including community cookouts, addiction treatment fairs, parades, school addiction awareness programs, and holiday celebrations.

• Opportunity to make a difference in lives every day.

• Medical, Dental, and Vision Insurance coverage.

• Paid Time Off (PTO).

• A variety of 401K options, including a matching program with no vesting period.

• Annual Continuing Education Allowance in a related field.

• Life Insurance coverage.

• Short and Long Term Disability Insurance.

• Paid maternity and paternity leave.

• Designated Mental Health days.

• Calm subscription available for all employees.