AR Specialist

This is a fully remote position, open to applicants in Florida, +6 more locations.

📋 Description

• Execute all aspects of insurance follow-up and collections, including making phone calls and accessing payer websites.

• Determine root causes of denials, categorize denial reasons, and facilitate process enhancements with clinics and management.

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

• Address complex or aged inventory, investigate payments, process payment recoups, and document collection activities.

• Assess account information and system applications to identify the next suitable work activity.

• Verify claims adjudication utilizing appropriate resources and applications.

• Reach out to patients via phone, electronically, or by letter to gather additional information as required.

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

• Manage and oversee individual work lists/inventory, complete reports, and resolve high-priority and aged inventory.

• Stay updated on changes in procedures and regulations for specific insurance carriers or payers.

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

• Carry out other 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, encompassing eligibility, authorization, medical necessity, and coding-related denials.

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

• Familiarity with common denial trends, including 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 interacting with both government and commercial payers.

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

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

• Excellent attention to detail and organizational abilities.

• Strong written and verbal communication skills.

• Minimum of a High School Diploma or equivalent.

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

🏝️ Benefits

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

• Short-term and long-term disability coverage.

• Optional life insurance available for employee, spouse, and child.

• Critical Illness insurance.

• Hospital Indemnity insurance.

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

• Paid time off.

• Paid holidays.

• Retirement Savings account.

• Employee discounts on cosmetic services and products.

• Continuous training and education opportunities.

• Intensive hands-on training provided.

• Opportunities for long-term career growth from within the organization.