AR Specialist

This is a fully remote position, open to applicants in Louisiana.

📋 Description

• Collaborate with external billing vendors to resolve claim rejections and respond to payer requests for clarification.

• Offer guidance and constructive feedback to vendor partners regarding claim corrections, rework, and resubmissions.

• Evaluate escalated accounts that require internal oversight or final resolutions.

• Identify trends in denials, recurring payer issues, and underlying root causes.

• Provide insights and strategic direction on appeal strategies and payment resolution methods.

• Approve final adjustments after all appeal opportunities have been exhausted, ensuring proper documentation and compliance.

• Suggest process enhancements aimed at minimizing future denials.

• Analyze A/R aging reports for accounts aged 30, 60, and 90+ days to pinpoint unpaid or underpaid claims.

• Initiate payer tracers and follow-ups to ensure claim adjudication and payment.

• Monitor high-risk and high-value accounts to prevent revenue loss.

• Accurately post and reconcile insurance and patient payments.

• Appropriately transfer payments to patient balances and process patient refunds in accordance with policy.

• Assist in account reconciliations and resolving discrepancies.

• Serve as a liaison between patients and insurance payers to clarify billing inquiries.

• Explain Explanation of Benefits (EOBs), patient responsibilities, and out-of-pocket costs.

• Conduct professional and empathetic phone communications with patients and payer representatives.

⛳️ Requirements

• High School Diploma or equivalent is required.

• An Associate’s or Bachelor’s degree in Healthcare Administration, Accounting, or a related field is preferred.

• 1–3 years of experience in medical billing and collections, Accounts Receivable or Revenue Cycle Management, or healthcare payer follow-up and denial resolution.

• Proficiency with Practice Management Systems and Electronic Health Records (EHR/EMR).

• Strong working knowledge of Microsoft Office, especially Excel (for reports and aging analysis) and SharePoint.

• Familiarity with medical terminology, CPT and ICD-10 coding, as well as payer guidelines and reimbursement rules for Medicare, Medicaid, and Commercial Insurance plans.

• Strong analytical and problem-solving capabilities.

• Exceptional attention to detail and accuracy.

• Effective written and verbal communication skills.

• Ability to collaborate effectively with internal teams and external vendor partners.

• Sound judgment in relation to financial adjustments and account resolutions.

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive healthcare plans including medical, dental, and vision coverage.

• Retirement savings plan with company match.

• Opportunities for professional development and growth.

• Flexible work schedule and remote work options.