AR Commercial Follow Up Specialist

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

📋 Description

• Oversee the accounts receivable inventory for commercial and specialty payers to ensure prompt follow-up and resolution of claims.

• Comply with quality and productivity benchmarks set by management.

• Process accounts for appeal when retroactive coverage has been secured.

• Identify payers that have been submitted via paper instead of electronically and communicate these opportunities to leadership.

• Conduct follow-ups on unpaid claims from commercial and third-party payers.

• Diligently pursue high-dollar accounts until a resolution is achieved.

• Review and interpret explanations of benefits and remittance advice.

• Ensure that statements are created for amounts owed by patients.

• Utilize insurance platforms to check and resolve claims.

• Perform detailed follow-ups on accounts and analyze problematic cases.

• Clearly document follow-up activities in the AR system.

• Audit and investigate accounts, payment postings, and contracts to verify the accuracy of account balances.

• Ensure timely documentation and submission of medical record requests.

• Work collaboratively with the denials team on complex or recurring denial issues.

• Complete assigned tasks within designated deadlines.

• Identify and report trends that could provide insights into payment obstacles.

• Reach out to patients, physician offices, attorneys, and others via phone for additional claim information.

• Attend seminars as required.

• Perform other duties as assigned.

⛳️ Requirements

• High School Diploma or GED is required.

• Minimum of 1 year of experience in patient registration, billing, or a related field.

• A working understanding of medical and insurance terminology is preferred.

• Capability to review, comprehend, and discuss HCFA billing with insurance or government entities.

• Familiarity with general insurance prerequisites.

• Experience handling EOBs and contractual adjustments directly.

• Basic computer skills and experience with electronic filing systems.

• Proficient verbal and written communication skills with a professional demeanor.

• Ability to meet set productivity goals.

• Comprehensive knowledge of the Uniformed Bill.

• Awareness of timely filing limits established by various payers.

• Familiarity with different payer websites for follow-up purposes.

• Strong understanding of commercial payer eligibility, benefits, determining primary payer, and covered benefits.

• Knowledge of billing policies related to auto and workers’ compensation, as well as incarcerated patient payers.

• Adherence to state and federal regulations.

🏝️ Benefits

• Full-time employment.

• First shift schedule (8:00 a.m.–4:30 p.m.).