Revenue Cycle Specialist II – AR & Denials Follow-Up

This is a fully remote position, open to applicants in Maryland, +3 more states.

📋 Description

• Conduct prompt and comprehensive follow-up on outstanding insurance accounts receivable claims and balances.

• Track the status of claims and engage with insurance providers to address unpaid, underpaid, and denied claims.

• Investigate and manage denials, reconsiderations, appeals, and payer requests for further information or medical records.

• Determine the underlying causes of claim denials and identify suitable resolutions.

• Examine claim history, payments, adjustments, charges, and account activity within the EHR.

• Analyze and interpret insurance documents, EOBs, remittance details, and responses from payers.

• Collaborate with providers and internal teams to gather necessary information, documentation, coding clarifications, or other actions.

• Keep precise records of accounts receivable follow-up activities and communications with payers.

• Adhere to HIPAA regulations when managing patient information and medical records.

• Input and update account and claim information within the computer system.

• Manage assigned accounts receivable inventory based on priorities, productivity standards, and follow-up timelines.

• Address correspondence related to accounts and respond to payer inquiries.

• Deliver customer service to patients and families concerning insurance balances.

• Operate both independently and collaboratively within a team to achieve departmental objectives.

• Uphold the confidentiality of patient and company information.

• Execute additional related duties as assigned.

⛳️ Requirements

• A minimum of 3–5 years of practical experience in medical insurance accounts receivable follow-up.

• Proven experience in insurance claim follow-up, handling denials, reconsiderations, and appeals.

• Strong knowledge of insurance payer requirements, claim processing, timely filing, authorizations, eligibility, coding-related denials, medical record requests, and common reimbursement challenges.

• Experience in researching unpaid and denied claims, assessing the right next steps, and accurately documenting follow-up actions.

• Capability to work independently and manage a substantial accounts receivable workload while meeting defined productivity and quality standards.

• High School diploma or equivalent.

• Experience in ENT is preferred but not mandatory.

• Applicants must currently live in Texas, Maryland, Virginia, or Pennsylvania.

🏝️ Benefits

• Competitive salary and benefits package.

• Opportunities for professional development and career advancement.

• Supportive work environment with a focus on teamwork and collaboration.

• Flexible working hours and potential remote work options.