AR Specialist

This is a fully remote position, open to applicants in Arizona, +6 more states.

📋 Description

• Conduct timely follow-up on California Medicare, Commercial, and Workers’ Compensation claims to guarantee prompt adjudication.

• Engage in direct communication with commercial payers, Medicare contractors, WC adjusters, case managers, and employers to gather claim status, validate authorizations, and clarify documentation requirements.

• Address claim rejections, underpayments, incorrect fee schedule applications, and missing documentation across various payer types.

• Monitor and manage Workers’ Compensation payer-specific timelines, including 30-day status cycles and state-mandated payment regulations.

• Oversee claims for timely filing, medical necessity, eligibility discrepancies, coordination of benefits, and modifier accuracy.

• Collaborate with authorization teams to verify authorization validity and ensure that necessary documentation is submitted prior to billing.

• Escalate delayed or complex cases to the relevant internal team members or external partners.

• Spot opportunities for appeal when claims are underpaid or inappropriately denied.

• Draft and submit appeal letters, reconsideration requests, and supporting documentation.

• Identify and report recurring denial patterns and work alongside billing, coding, and authorization teams to prevent future occurrences.

• Take on additional responsibilities as needed based on the position and organizational requirements.

• Contribute to Boomerang Healthcare’s revenue cycle management operations for multidisciplinary pain-care services.

⛳️ Requirements

• High school diploma or GED is mandatory.

• A minimum of 3 years of accounts receivable follow-up experience with a strong focus on California Medicare and Commercial billing.

• Proficient understanding of Workers’ Compensation billing, including communication with adjusters, state regulations, medical necessity, and necessary documentation.

• Experience in managing mixed payer accounts receivable inventories with conflicting timelines and requirements.

• Capability to operate in a fast-paced environment, meet daily deadlines, and work collaboratively with cross-functional revenue cycle management teams.

• Familiarity with various EHR / Practice Management systems (IMS, NextGen, Athena, eClinicalWorks, or similar).

• Basic knowledge of NCCI edits and payer-specific billing guidelines.

• Excellent verbal and written communication skills with a keen attention to detail.

• Advanced proficiency in Microsoft Excel (including formulas and pivot tables) and solid skills in other Microsoft Office applications.

• Availability required Monday to Friday, 8 AM to 5 PM.

• Commitment to working 40 hours per week.

🏝️ Benefits

• Exceptional work/life balance.

• Comprehensive Medical, Dental, Vision, and Prescription benefits (PPO & HMO).

• 401(K) Plan with Employer Matching.

• Reimbursements for Licenses & Tuition.

• Paid Time Off.

• Holiday Pay & Floating Holidays.

• Employee Perks and Discount Programs.

• A supportive environment to foster your growth and success.

• Opportunity for remote work arrangements.