AR Specialist

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

📋 Description

• Conduct follow-up and collection activities with insurance companies, which includes making phone calls and accessing payer websites.

• Analyze the underlying causes of claim denials, classify denial reasons, and collaborate with clinics and management to enhance processes.

• Take ownership of performance and ensure consistent, timely communication regarding reimbursement challenges.

• Address intricate or aged inventory issues, including payment research and recoupment, with minimal or no supervision.

• Precisely document all collection activities.

• Review account details and system applications to determine the next appropriate steps.

• Validate claims adjudication using relevant resources and applications.

• Reach out to patients via phone, electronically, or through mail to gather additional information.

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

• Organize and manage individual work lists/inventory effectively.

• Generate reports and address high-priority and aged inventory issues.

• Stay up-to-date with procedures and regulations pertaining to specific insurance carriers or payers.

• Convey payer, system, and escalated account concerns to management and collaborate on solutions.

• Carry out additional tasks 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 adhering to productivity and quality standards.

• Familiarity with common denial trends, including those associated with modifiers (e.g., Modifier 25, 59, RT/LT) and specific billing requirements of payers.

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

• Experience working with both governmental and commercial payers.

• Proficient in analyzing EOBs, remits, and claim specifics to determine the next steps.

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

• Exceptional attention to detail and organizational abilities.

• Strong written and verbal communication skills.

• A minimum of a High School Diploma or equivalent is required.

• Candidates must reside in PA, MD, VA, NC, TN, GA, or FL.

🏝️ Benefits

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

• Short-term and long-term disability coverage.

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

• Critical Illness insurance available.

• Hospital Indemnity insurance provided.

• Basic Life/AD&D insurance at no cost to employees.

• Paid time off and holidays.

• Retirement Savings account options.

• Employee discounts on cosmetic services and products.

• Opportunities for continual training and education.

• Comprehensive hands-on training provided.

• Long-term career advancement opportunities from within the organization.

• Remote work arrangements available.