Accounts Receivable Specialist

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

📋 Description

• Review, assess, and process submitted claims for accuracy, including charges, subscriber information, diagnosis and procedure codes, late fees, and supporting documentation.

• Submit claims promptly in accordance with payer agreements, federal and state regulations, departmental standards, and form specifications.

• Follow up with commercial, governmental, and other payers via phone, correspondence, and electronic systems to address unpaid, underpaid, denied, or rejected claims.

• Identify the causes of denials, underpayments, and payment delays, and take corrective measures to ensure reimbursement.

• Prepare, draft, and submit technical and clinical appeals with comprehensive and accurate documentation.

• Re-bill accounts upon receipt of updated demographic, insurance, or third-party information and ensure patient records are updated accordingly.

• Verify insurance, payer, and patient demographic details, entering verification data into billing systems.

• Review reports to track claim status, payment discrepancies, denial patterns, and outstanding accounts.

• Document account activity, including payer communications, correspondence, and actions taken, in the host system or tracking tools.

• Maintain awareness of payer-specific requirements, contracts, and relevant regulations.

• Identify trends in accounts receivable and their root causes, communicating findings and recommendations to management.

• Establish appropriate collection strategies to resolve accounts.

• Meet productivity and quality benchmarks.

⛳️ Requirements

• At least one year of experience in Revenue Cycle/Medical billing, follow-up and collections, or a relevant degree/certification in Healthcare Management.

• Proficient in basic computer applications, including Microsoft Excel.

• High school diploma or GED preferred.

• Excellent verbal and written communication skills.

• Must be at least 18 years old.

• Ability to move freely, including standing, stooping, walking, bending, pushing, and pulling.

• Capability to lift up to 25 pounds without assistance.

🏝️ Benefits

• Lifestyle Engagement benefits, including health coaches, relaxation rooms, health-focused applications (Wonder, Ripple), and mental health support.

• Access & Affordability benefits, encompassing minimal or no copays, team member cost-sharing premiums, and daycare assistance.

• Ongoing opportunities for learning and professional development.

• Accessible and transparent leadership.

• A commitment to work/life balance.