Accounts Receivable Specialist
- Claims Management: Monitor and follow up on unpaid and denied medical claims across a variety of payers (commercial, Medicare, Medicaid, etc.) to ensure timely reimbursement.
- Denial Resolution: Research, analyze, and resolve claim denials and underpayments by identifying root causes, correcting errors, submitting appeals, or providing additional documentation as needed.
- Account Reconciliation: Reconcile accounts receivable by posting adjustments and resolving discrepancies to maintain accurate financial records.
- Trend Analysis & Reporting: Generate and analyze A/R reports to identify patterns in denials, reimbursement delays, or system inefficiencies, and recommend process improvements.
- Collaboration: Partner with billing, coding, and compliance teams to ensure claims are processed accurately and efficiently.
- Compliance: Maintain strict adherence to HIPAA regulations, payer-specific guidelines, and company policies to ensure data integrity and patient confidentiality
- Experience: Minimum of 5 years of experience in medical billing or accounts receivable with a strong emphasis on insurance claim resolution and denial management.
- Knowledge: In-depth understanding of medical billing and coding principles (CPT, ICD-10, HCPCS) and payer reimbursement methodologies.
- Technical Skills: Proficiency with medical billing software; experience with NextGen Billing strongly preferred. Waystar Clearinghouse expertise required.
- Analytical Skills: Strong ability to interpret EOBs, remittance advice, and payer correspondence to resolve complex claim issues.
- Attention to Detail: Exceptional accuracy in data entry, financial reconciliation, and documentation.
- Communication Skills: Effective written and verbal communication skills to interact with payers, internal teams, and external stakeholders in a professional manner.
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