Accountabilities:

As an Accounts Receivable Specialist, you will manage claim follow-up activities, investigate payment issues, and support accurate reimbursement processes. You will apply healthcare billing knowledge, maintain documentation standards, and collaborate with payers and internal stakeholders to resolve outstanding accounts.

• Verify eligibility and authorization information through payer websites, client systems, and direct communication with insurance providers.
• Update patient demographic and insurance details accurately within appropriate systems.
• Research unpaid, rejected, and denied claims to determine resolution strategies.
• Monitor claims for missing information, authorization details, and required control numbers.
• Review Explanation of Benefits (EOBs) to identify payments, adjustments, and opportunities for claim resolution.
• Contact insurance payers through phone and written communication to secure payments and manage reconsiderations or appeals.
• Access healthcare systems to review payment information, patient records, claims data, and related documentation.
• Follow established workflows, prioritization guidelines, timely filing requirements, and documentation procedures.
• Obtain and submit necessary medical documentation requested by insurance carriers.
• Maintain confidentiality of patient information in accordance with healthcare privacy standards and organizational policies.
• Support additional revenue cycle activities and operational tasks as needed.

Requirements:

The ideal candidate has experience in healthcare collections, claims resolution, and denial management, with strong knowledge of medical billing processes and payer requirements. You should be detail-oriented, organized, and comfortable working with healthcare data systems.

• 2–3 years of experience in medical collections, denials management, and appeals processes.
• Experience handling complex denials, including DRG downgrades, level of care, coding, and medical necessity issues.
• Intermediate knowledge of ICD-10, CPT, HCPCS, and NCCI coding standards.
• Strong understanding of third-party billing guidelines and reimbursement processes.
• Knowledge of healthcare claim forms, including UB-04 and CMS-1500.
• Experience working with commercial and government payer contracts.
• Intermediate proficiency with Microsoft Word and Excel.
• Experience using healthcare information systems such as EMR platforms, claim scrubbers, and patient accounting systems.
• Preferred experience with patient accounting systems such as EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, Allscripts, or Paragon.
• Knowledge of Medicare DDE claim systems and government healthcare regulations is a plus.
• Strong communication, organization, and problem-solving skills.

Benefits:

• Competitive compensation range of $19–$22 per hour, based on experience, skills, certifications, and location.
• Fully remote work opportunity available across the United States.
• Full-time employment with opportunities to develop expertise in healthcare revenue cycle operations.
• Opportunity to work on meaningful healthcare financial processes that support better patient and provider experiences.
• Exposure to complex claims, payer relationships, and healthcare billing systems.
• Collaborative remote work environment focused on service, teamwork, and professional growth.