Accounts Receivable Specialist

About the Role

The Accounts Receivable Specialist will focus on engaging directly with both commercial and government healthcare payers to resolve claim issues and facilitate timely reimbursement. This position requires analyzing denied and underpaid claims, initiating technical appeals, and ensuring accurate and prompt payment processes.

Key Responsibilities

• Deliver outstanding client service by understanding and exceeding the expectations of clients, patients, and colleagues.
• Innovate continuously by adopting new technologies and encouraging creative approaches.
• Investigate denied and underpaid claims to identify causes of discrepancies.
• Engage in direct communication with payers to follow up on claims, file appeals, and resolve payment inconsistencies.
• Diagnose reasons for payment delays, underpayments, and denials, and collaborate with management to identify root causes and trends.
• Maintain up-to-date knowledge of federal/state regulations and payer-specific requirements to ensure compliance.
• Precisely document interactions, including contact details and follow-up actions.
• Proactively make recommendations and communicate recurring issues or trends to management.
• Use problem-solving and critical-thinking skills to resolve account issues while meeting productivity and quality benchmarks.
• Perform other assigned duties as needed.

Preferred Candidate Profile

• Any graduate with 2 to 5 years of experience in medical collections, physician or hospital operations, AR follow-up, denials and appeals, compliance, provider relations, or professional billing.
• Strong analytical skills and proficiency in MS Word, Excel, and PowerPoint.
• Effective communication skills, both written and verbal.
• Solid understanding of US healthcare systems, including Revenue Cycle Management.
• Knowledgeable about Medicare and Medicaid programs.
• Ability to collaborate positively with team members, peers, and leadership.