Accounts Receivable Representative

About Impact Advisors

Impact Advisors, LLC is a nationally acclaimed healthcare management consulting company known for providing top-ranked advisory, implementation, and optimization solutions. Our focus lies in exceeding client expectations and partnering with leading healthcare organizations across the nation. Our mission emphasizes driving patient-centered and value-based outcomes, earning us distinguished recognition within the industry.

Job Overview

We are searching for a proactive and detailed-oriented Accounts Receivable Representative responsible for managing unpaid, underpaid, or denied insurance claims. This role involves investigating payment issues, resolving denials, submitting appeals, and conducting end-to-end processing of daily financial transactions. Familiarity with electronic health records systems, clearinghouses, payer portals, and accounting procedures is essential.

Responsibilities

• Follow up on unpaid or underpaid insurance claims, reviewing claim statuses via payer portals, IVR systems, and clearinghouses.
• Manage assigned work queues while achieving expected productivity levels.
• Resolve claim denials independently, including issues related to medical necessity, authorization, coding discrepancies, payer policies, and timely filing exceptions.
• Conduct formal appeals by reviewing medical records, preparing narratives, and escalating issues to payers.
• Analyze remittance advice to detect underpayments, takebacks, and identify trends in payer behavior.
• Maintain comprehensive records of all accounts receivable transactions, including invoices, statements, and correspondence with customers.
• Monitor account activity to detect non-payment, payment delays, and other anomalies.
• Adhere to all relevant federal, state, and internal policies and regulations.
• Execute routine financial activities such as verifying, classifying, and recording accounts receivable data.

Qualifications

• Minimum of a High School Diploma or GED; Associate’s or Bachelor’s degree in health information management or related fields preferred.
• Demonstrated experience in healthcare accounts receivable, billing, or revenue cycle operations.
• Fundamental knowledge of healthcare revenue cycle principles.
• High attention to detail with eagerness to understand payer rules.
• Ability to adhere to structured processes and workflows.
• Experience handling appeals and resolving denial cases.

Preferred Experience

• Capability to manage complicated, high-value, and aged accounts receivable (greater than 120 or 180 days).
• Working knowledge of Medicare, Medi-Cal, and Medi-Cal Managed Care billing processes.
• Background in high-volume or managed service healthcare environments.
• Willingness to travel quarterly to client sites.

Skills and Abilities

• Strong relationship-building skills across all organizational levels with a commitment to delivering exceptional customer service to patients.
• Effective listening and clear communication abilities.
• Consistent professionalism in all interactions.
• Physical capability to sit, stand, and walk for prolonged periods as needed.

Compensation and Benefits

Eligible salaried employees may receive annual performance bonuses. Additional benefits and perks depend upon the specific role and employment conditions, reflecting qualifications, skill level, and organizational requirements.

Culture

Impact Advisors fosters a supportive, transparent, and autonomous workplace culture that values diversity and inclusion. Our team shares a collective commitment to making a positive difference in healthcare and supporting each other professionally and personally.