AR Specialist

This is a fully remote position, open to applicants in Florida, +5 more states.

📋 Description

• Conduct insurance follow-up and collection activities, which include making telephone calls and accessing payer websites.

• Determine the underlying causes of denials, classify denial reasons, and collaborate on process enhancements with clinics and management.

• Utilize a fundamental understanding of coding-related denials within procedural specialties.

• Take ownership of performance and communicate about reimbursement issues in a consistent and timely manner.

• Address complex or aged inventory, including researching payments and managing payment recoups.

• Accurately and thoroughly document collection activities.

• Examine account information and system applications to ascertain the next steps in the workflow.

• Confirm claims adjudication using relevant resources and applications.

• Reach out to patients via telephone, electronically, or through written correspondence to gather additional information.

• Edit claims to ensure compliance with billing guidelines for electronic submissions.

• Organize and manage personal work lists/inventory, complete reports, and resolve high-priority and aged inventory items.

• Keep updated on changes in procedures and laws for specific insurance carriers or payers.

• Relay payer, system, and escalated account issues to management and contribute to developing solutions.

• Perform additional duties as assigned by management.

⛳️ Requirements

• At least 3 years of experience in healthcare accounts receivable or the revenue cycle.

• Proven experience in identifying and resolving insurance denials, including those related to eligibility, authorization, medical necessity, and coding.

• Capability to manage an individual work queue while achieving productivity and quality standards.

• Proficient understanding of common denial trends, including modifier-related denials (e.g., Modifier 25, 59, RT/LT) and specific payer billing requirements.

• Strong comprehension of insurance denials, appeals, and claims follow-up processes.

• Experience with both government and commercial payers.

• Ability to analyze EOBs, remittances, and claim details to determine the appropriate next steps.

• Comfortable working independently in a remote setting while meeting productivity expectations.

• Excellent attention to detail and organizational abilities.

• Strong written and verbal communication skills.

• Minimum requirement of a high school diploma or equivalent.

• Residency in Pennsylvania, Maryland, Virginia, North Carolina, Tennessee, Georgia, or Florida.

🏝️ Benefits

• Ongoing training and educational opportunities.

• Comprehensive hands-on training.

• Long-term career advancement opportunities within the company.

• Medical, Dental & Vision insurance – effective on the 1st of the month following the start date.

• Short-term and long-term disability coverage.

• Voluntary life insurance for employees, spouses, and children.

• Critical Illness insurance.

• Hospital Indemnity insurance.

• Company-sponsored Basic Life/AD&D insurance.

• Paid time off.

• Paid holidays.

• Retirement savings account.

• Employee discounts on cosmetic services and products.