Accounts Receivable Specialist – RCM

This is a fully remote position, open to applicants in Alaska, +2 more states.

📋 Description

• Executes advanced tasks associated with denial management.

• Expertly processes and follows up on all types of appeals across all payers.

• Takes necessary actions to resolve outstanding claims, including refiling or appealing claims and addressing tasks assigned to accounts receivable for review.

• Manages outstanding accounts receivable from designated projects.

• Serves as a subject matter expert across multiple workflows and various payers.

• Offers training support to peers regarding payers and systems.

• Recognizes denial trends and escalates issues to management for further investigation and root cause resolution.

• Suggests improvements to work queues and claim edits to enhance efficiency and minimize denials.

• Analyzes payer communications regarding updates in medical and reimbursement policies.

• Investigates payer trends highlighted by offshore partners to propose training and process enhancements.

• Identifies and actively engages in process improvement opportunities.

• Ensures the highest level of confidentiality is maintained.

• Demonstrates basic proficiency in using spreadsheets.

• Upholds productivity and quality standards determined by revenue cycle management.

• Performs any other duties as assigned.

⛳️ Requirements

• High school diploma or equivalent is required.

• An associate or bachelor’s degree in business administration or a related field is preferred.

• A minimum of 3 years of experience in accounts receivable is preferred.

• Exceptional verbal and written communication skills to maintain professionalism in all forms of communication.

• Basic mathematical skills for calculating anesthesia units, appropriate reimbursement, and percentage adjustments.

• General understanding of medical terminology.

• Advanced knowledge of insurance processing, payer policies, guidelines, and explanations of benefits (EOBs).

• Familiarity with commercial payer, Medicare, and Medicaid guidelines.

• High accuracy in data entry skills.

• General knowledge and understanding of CPT, ICD-10, and ASA codes.

• Strong problem-solving abilities.

• Decisive judgment skills with sound reasoning.

• Excellent analytical skills and attention to detail, including the ability to gather and synthesize information.

• Ability to collaborate effectively with all team members, including physicians, external vendors, and patients.

• Must be able to work in a virtual team setting.

• Capability to work independently with minimal supervision.

• Proficient in computer applications, including MS Word, MS Excel, MS Outlook, and MS Teams.

🏝️ Benefits

• Eligible for a quarterly bonus.