Accounts Receivable Specialist

Accountabilities

• Manage accounts receivable throughout the full claims lifecycle, including claim submission, payment follow-up, denial research, resolution, and appeals.
• Monitor aging reports and follow up with insurance carriers on unpaid or underpaid claims to maximize appropriate reimbursement.
• Investigate and resolve claim denials, payment discrepancies, and billing issues, submitting appeals with the necessary supporting documentation.
• Maintain accurate patient demographic, guarantor, insurance, billing, diagnosis, procedure, modifier, and provider information.
• Submit claims through clearinghouses or directly to payers and process claim retractions, write-offs, and contractual adjustments according to payer guidelines.
• Review insurance payments for accuracy and contract compliance, post insurance and patient payments, and reconcile daily deposits.
• Coordinate secondary billing when patients have multiple insurance plans and verify eligibility and benefits coverage.
• Interpret Explanation of Benefits statements, calculate deductibles and coinsurance, and apply knowledge of Medicare, Medicaid, workers’ compensation, and other insurance requirements.
• Respond to inquiries from patients, providers, and insurance companies while providing professional, tactful, and effective customer service.
• Collaborate with team leaders and cross-functional departments to communicate updates, escalate issues, improve workflows, and resolve broader operational challenges.
• Protect patient information and maintain strict confidentiality while adhering to HIPAA and other applicable compliance requirements.
• Contribute to process improvements and demonstrate flexibility, initiative, accountability, and a willingness to support colleagues and evolving business needs.

Requirements

• High school diploma or GED required; an associate degree in Healthcare Management, Health Information Management, or a related discipline is preferred.
• At least 3 years of healthcare billing accounts receivable experience, preferably within a mid-to-large organization or complex physician practice environment.
• Experience working with an electronic medical record (EMR) platform such as Epic or ClinicalWorks is preferred.
• Working knowledge of CPT and ICD coding, medical terminology, insurance guidelines, and healthcare reimbursement processes.
• Ability to accurately interpret Explanation of Benefits (EOBs), calculate deductibles and coinsurance, and identify discrepancies in payments or claims.
• Strong understanding of payer requirements, including Medicare, state Medicaid programs, and workers’ compensation across multiple states.
• Experience with healthcare accounts receivable, claims processing, denials, appeals, payment posting, and insurance follow-up.
• CPAR certification, Certified Medical Billing Specialist credentials, or comparable professional certification is a plus.
• Proficiency with Microsoft Office applications, particularly Excel and Word, along with strong computer and typing skills.
• Excellent attention to detail, mathematical accuracy, organization, and time-management skills, with the ability to prioritize multiple tasks effectively.
• Strong verbal and written communication, phone etiquette, interpersonal, and customer-service skills.
• Ability to communicate financial responsibilities and billing matters professionally and sensitively with patients and other stakeholders.
• Demonstrated ability to collaborate across departments, remain productive under pressure, share information proactively, and contribute to enterprise-wide problem solving.
• Commitment to patient confidentiality, professional integrity, accountability, and compliance with applicable healthcare regulations.

Benefits

• Fully remote work arrangement.
• Full-time employment opportunity.
• Competitive benefits designed to support employees and their overall well-being.
• Medical and dental plan options.
• Company-paid vision coverage.
• 401(k) retirement plan.
• Paid parental leave for eligible employees starting on day one.
• Employer-paid short- and long-term disability insurance.
• Employer-paid life insurance.
• Critical illness, accident, and hospital indemnity insurance options.
• Employee Assistance Program (EAP).
• Paid time off, with accrual based on applicable employment status and tenure.
• Annual paid holidays, including additional extended company holidays.
• Access to employee discounts and wellness resources, including fitness, financial wellness, mental health, and other support programs.
• Opportunities to work collaboratively across healthcare and operational teams in a remote environment.