Accounts Receivable Specialist

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

📋 Description

• Take charge of and manage aged accounts receivable, focusing on the most valuable and oldest outstanding claims to enhance collection efforts.

• Examine unpaid, underpaid, and denied claims to identify root causes and actively pursue resolutions directly with payers.

• Oversee the complete denials and appeals process, ensuring timely attention to denials and relentless pursuit of appeals until a resolution is achieved.

• Perform payer follow-ups via phone and online portals, escalating and documenting each step until claims are fully resolved.

• Recognize and report emerging claim issues, denial trends, and payer behaviors, escalating to leadership along with actionable recommendations.

• Review and manage overpayments, initiate recoupment processes when necessary, and confirm that payers accurately post reconciliations.

• Conduct monthly audits each quarter to identify missed billing, unacknowledged claims, and aging accounts that require action.

• Collaborate with providers to write off uncollectible claims only after sufficient appeals and collection efforts have been made.

• Offer assistance with primary and secondary claim submissions and payment postings as needed.

• Monitor and manage assigned tasks in Lumary, including communications with providers.

⛳️ Requirements

• Experience in collections or accounts receivable is essential, with a proven history of working with aged AR, denials, and appeals—preferably within a medical billing or healthcare revenue cycle management environment.

• Strong investigative skills. You delve into the details, ask pertinent questions, and do not rest until you uncover why a claim is not being paid and have resolved the issue.

• In-depth understanding of the medical claim lifecycle, denials management, and payer reimbursement procedures.

• Confident and persistent in following up with payers and handling appeals, with excellent documentation and follow-through capabilities.

• Familiarity with Electronic Remittance Advice (ERA)/Explanation of Benefits (EOB) processing and electronic claim submissions.

• Previous experience in Medicaid billing is required.

• Experience in ABA or behavioral health billing is advantageous.

• Detail-oriented with a strong sense of accountability and a solutions-driven mindset, collaborating with senior team members to achieve resolutions.

🏝️ Benefits

• Flexibility to work from home and the office, offering a hybrid working environment for those based at an office location in Denver, or fully remote for individuals located outside the Denver area.

• Flexible start and end times, allowing for a routine while accommodating personal appointments or early departures when necessary.

• Monthly town halls for fostering connection and alignment within the company.

• Dedicated Social Connection days each month to enhance team bonding.

• Quarterly employee engagement surveys, with current engagement at 82% and on an upward trend.

• Join an internationally expanding company that is committed to a meaningful vision: Empowering sustainable healthcare.