Accounts Receivable Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• The Accounts Receivable Specialist is tasked with directly following up with commercial, governmental, and other payers to address claim payment issues, ensuring appropriate and timely reimbursement and responses.

• Analyzes and identifies denials, payment discrepancies, and claims without response, taking necessary actions to resolve claims/accounts, including drafting and submitting both technical and clinical appeals.

• Provides assistance for all denial, no response, and audit-related activities.

• Reviews denied and other unpaid claims to ascertain the reasons for discrepancies.

• Engages directly with payers to follow up on outstanding claims, files technical and clinical appeals, resolves payment discrepancies, and guarantees timely and accurate reimbursements.

• Capable of identifying specific reasons behind underpayments, denials, and delays in payment.

• Collaborates with management to identify, analyze, and address root causes of issues within Accounts Receivable.

• Maintains a comprehensive understanding of federal and state regulations, as well as payer-specific requirements, taking appropriate actions as needed.

• Accurately documents all activities, including contact names, addresses, phone numbers, and other relevant information in the client’s host system and/or suitable tracking system.

• Shows initiative and resourcefulness by making recommendations and communicating trends and issues to management. A strong problem solver and critical thinker is essential for resolving accounts.

⛳️ Requirements

• Must possess basic computer knowledge and demonstrate proficiency in Microsoft Excel.

• Excellent verbal communication skills.

• Strong problem-solving abilities, with the capacity to assess accounts and formulate a collection action plan.

• Critical thinking skills, enabling comprehension of tools provided for securing payment, and the application of these tools to various accounts to ensure payment.

• Adaptable to changing procedures and a dynamic environment.

• Must meet quality and productivity standards according to timelines established in policies.

• Adherence to required attendance policies is necessary.

• Must be inquisitive and open to innovation, including the use of AI, to explore better processes and enhance patient and client experiences.

• A 2 or 4-year college degree is required.

• Preferably, 1 or more years of relevant experience in medical collections, physician/hospital operations, AR follow-up, denials & appeals, compliance, provider relations, or professional billing.

• Knowledge of claims review and analysis is advantageous.

• Familiarity with the revenue cycle is necessary.

• Experience with the DDE Medicare system and using payer websites to investigate claim statuses is beneficial.

• A working knowledge of medical terminology and/or insurance claim terminology is required.

🏝️ Benefits

• Bonus incentives.

• Paid certifications.

• Tuition reimbursement.

• Comprehensive benefits package.

• Opportunities for career advancement.