AR Specialist

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

📋 Description

• Accountable for all facets of insurance follow-up and collections, which includes making phone calls and accessing payer websites.

• Determine root cause issues for denials; classify denial reasons and collaborate with clinic staff and/or management to ensure that process improvements are implemented.

• Takes ownership of performance and guarantees consistent and timely communication regarding issues affecting reimbursement.

• Successfully resolve intricate or aged inventory, including payment research and payment recoups with minimal or no assistance required; accurately and comprehensively document relevant collection activities conducted.

• Examine account information and necessary system applications to ascertain the next suitable work activity.

• Confirm claims adjudication using appropriate resources and applications.

• Modify claims to comply with billing compliance guidelines for electronic submission.

• Oversee and maintain an individual work list/inventory, complete reports, and address high-priority and aged inventory.

• Remain updated on changes to procedures and laws related to specific insurance carriers or payers.

• Clearly communicate issues to management, including those related to payers, systems, or escalated accounts, while also developing solutions.

⛳️ Requirements

• At least 3 years of experience in healthcare accounts receivable or 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 meeting productivity and quality standards.

• Familiarity with common denial trends, such as modifier-related denials (e.g., Modifier 25, 59, RT/LT) and payer-specific billing requirements.

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

• Experience working with both government and commercial payers.

• Ability to analyze EOBs, remits, and claim details to ascertain appropriate next steps.

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

• Excellent attention to detail and organizational skills.

• Proficient in written and verbal communication.

🏝️ Benefits

• Medical, Dental, and Vision insurance (effective the 1st of the month following start date).

• Short-term and long-term disability coverage.

• Voluntary life, critical illness, and hospital indemnity insurance.

• Company-paid Basic Life and AD&D insurance.

• Paid time off and paid holidays.

• Retirement savings plan.

• Employee discounts on cosmetic services and products.