Accounts Receivable Specialist

About the Role

The Accounts Receivable Specialist at Oshi Health will oversee insurance accounts receivable to ensure timely payments and accurate posting and reconciliation of claims. This position aims to maximize reimbursement by following up on claims, resolving denials, investigating payments, and maintaining precise financial records. The role collaborates with revenue cycle leadership, finance, and clinical teams to address discrepancies and enhance AR performance. The specialist will also assist in reporting and analyze trends to boost revenue cycle operations and contribute to Oshi Health’s innovative approach to GI care.

Key Responsibilities

• Manage assigned insurance AR to ensure prompt reimbursement and minimize aging balances.
• Communicate with insurance payers regarding unpaid claims, payment underallocations, denials, and discrepancies.
• Resolve claim denials by correcting claims, filing appeals, reconsiderations, and submitting necessary documentation per payer policies.
• Analyze claim edits and rejections for accurate resubmission, reducing future denials.
• Post insurance payments, adjustments, and remittances accurately in billing systems.
• Perform daily payment reconciliations ensuring consistency between posted payments, ERA, EOB, bank deposits, and payment reports.
• Investigate and resolve unapplied funds, payment variances, overpayments, and underpayments.
• Compare payer payments with contracted reimbursement and escalate discrepancies when needed.
• Keep detailed records of AR activities, communications with payers, and resolutions achieved.
• Respond empathetically and professionally to patient inquiries about insurance claims, billing, payments, balances, and company policies.
• Maintain communication with providers, payers, and internal teams to prevent and resolve claim/payment issues.
• Collaborate with Billing, Eligibility, Credentialing, Finance, and Clinical Operations teams to resolve reimbursement difficulties and improve revenue cycle results.
• Assess AR, payment, and denial data to identify patterns, root causes, and improvement opportunities.
• Monitor and report on key AR performance metrics including aging, denials, payment accuracy, and provide leadership with insights and recommendations.
• Support month-end closing, payment balancing, reporting tasks, and audits.
• Identify recurring issues in reimbursement or operations and propose process enhancements to enhance payment accuracy and expedite collections.
• Ensure compliance with company policies, payer rules, financial regulations, HIPAA, and healthcare billing standards with integrity and accuracy.

Qualifications and Experience

• Bachelor's degree in Business Administration or related coursework.
• At least 2 years of healthcare revenue cycle experience focusing on accounts receivable, payment posting, or insurance billing.
• Knowledge of medical billing, insurance claims processing, and payer reimbursements.
• Proven ability to handle claim denials, underpayments, and payment discrepancies.
• Experience posting payments and reconciling ERAs, EOBs, deposits, and unapplied cash.
• Comfort and success in a remote working environment with independent priority management.
• Proficiency with electronic medical records (EMR) and billing software.
• Excellent analytical, problem-solving, organizational, and communication skills with high attention to detail.
• Competence in Google Workspace (Sheets, Docs, Gmail) and ability to quickly learn new platforms.
• Preferred experience includes working in a startup or fast-growing healthcare setting, telehealth/virtual care exposure, payer contract reimbursement analysis, familiarity with payer portals and clearinghouses, and certifications such as CRCR, CPB, or CPC.
• Experience with systems like Athenahealth, Apero, and Salesforce is also advantageous.

Compensation and Benefits

• Annual salary range from $47,000 to $52,000, with additional bonus opportunities.
• Comprehensive employer-paid medical, dental, and vision insurance coverage.
• Unlimited paid time off plus 11 company holidays.
• 401(k) plan with eligibility to contribute.
• Remote-first work environment restricted to specified US states.
• Personalized professional development opportunities for career growth.
• Life concierge services to support personal needs.

Work Location and Schedule

This role is fully remote but limited to candidates residing in Arizona, Delaware, Florida, Georgia, Idaho, Indiana, Louisiana, Missouri, New Hampshire, North Carolina, South Carolina, Tennessee, Texas, Vermont, or Virginia, with commitment to remain within these states. The working hours are Monday through Friday, 9 AM to 6 PM EST.

Additional Information

Oshi Health is committed to diversity, equity, and inclusion by fostering a respectful workplace free from discrimination and harassment, consistent with all applicable laws. Their equal opportunity employment policies cover all employment aspects. Candidates should be aware that Oshi Health does not communicate via messaging apps and official correspondence will only be through email. They warn against scams asking for personal financial information or purchases as part of the hiring process.