Accounts Receivable Specialist

The Accounts Receivable Specialist supports healthcare revenue cycle operations by researching and resolving unpaid insurance claims, investigating denials, submitting appeals, reconciling accounts, and ensuring timely reimbursement. This role works extensively with insurance carriers, payer portals, EOBs, claim status reviews, account corrections, and denial resolution activities.

Representatives are responsible for managing assigned accounts receivable inventories, identifying reimbursement issues, maintaining accurate account documentation, and collaborating with insurance companies and partner facilities to resolve claim-related concerns. This position requires strong revenue cycle knowledge, insurance claims expertise, and the ability to work independently in a fast-paced healthcare environment.

### Key Responsibilities

* Investigate and resolve unpaid, denied, underpaid, and delayed claims
* Submit written appeals with supporting documentation
* Verify insurance eligibility and identify payer changes
* Update coordination of benefits (COB) information accurately
* Navigate payer portals to determine claim status and reimbursement information
* Make outbound calls to insurance carriers and facility business offices
* Answer incoming calls related to claim resolution activities
* Identify denial trends and coding-related issues
* Support clean claim processing initiatives
* Reconcile accounts and identify overpayments
* Process refund requests and insurance takebacks through ERAs
* Maintain detailed account documentation and AR logs
* Meet department productivity and quality standards
* Collaborate with internal teams and external payer contacts

### Requirements

* Minimum 3 years of medical billing and accounts receivable experience required
* Advanced understanding of healthcare revenue cycle processes
* Strong knowledge of insurance claims processing
* Ability to read and interpret EOBs
* Knowledge of insurance denials and appeals processes
* Knowledge of ICD-10, CPT, HCPCS, and CMS-1500 claim forms
* Intermediate Microsoft Excel skills
* Proficiency with Outlook and Word
* Strong critical thinking and problem-solving skills
* Excellent organization and time management abilities
* Strong verbal and written communication skills
* Ability to work independently and adapt to changing workflows

### Preferred Qualifications

* CPB certification preferred
* CPC or CPC-A certification preferred
* Experience with denial management and reimbursement recovery
* Experience with ERA processing and account reconciliation

### Benefits

* Medical, Dental, Orthodontic, Vision, and Prescription Coverage
* 80% Employer-Paid Employee Medical Premiums
* Life Insurance, AD&D, and Disability Coverage
* Voluntary Supplemental Benefits
* 401(k) with Employer Match
* Up to 132 Hours PTO in First Year
* 8 Paid Holidays
* Up to $2,000 Annual Professional Development Reimbursement
* Remote Work Flexibility
* Collaborative Team Environment

### Good Fit For

This role may be a strong fit for candidates with experience in medical billing, healthcare accounts receivable, insurance follow-up, denial management, reimbursement recovery, payment posting, claims appeals, EOB review, revenue cycle management, collections, or healthcare financial operations.