Accounts Receivable specialist

Hands-On Medical AR Specialist — Denials, Appeals & Payer Follow-Up
We are seeking an experienced Accounts Receivable (AR) Specialist to personally review and resolve unpaid, underpaid, rejected, and denied medical claims. This is a hands-on production role—not a position supervising an AR team.
The candidate must have a minimum of 3–4 years of dedicated, hands-on medical AR experience, including interpreting EOBs and ERAs, investigating denials, correcting claims, submitting appeals, and following up directly with insurance companies.
Responsibilities
Manually review individual claims alongside the submitted billing information, Explanation of Benefits (EOB), Electronic Remittance Advice (ERA), and payer correspondence.
Identify the specific reason a claim was denied, rejected, underpaid, or left unpaid, and determine the appropriate next action.
Correct and submit claims, corrected claims, reconsiderations, and appeals through payer portals or other required channels.
Prepare appeal submissions with supporting documentation and track them through resolution.
Call insurance companies when portal information is insufficient or additional follow-up is necessary.
Review primary, secondary, and tertiary insurance processing, coordination of benefits, and patient responsibility.
Monitor timely-filing and appeal deadlines and prioritize claims at risk.
Maintain clear account notes documenting findings, actions, payer reference numbers, deadlines, and the next follow-up date.
Coordinate patient outreach with the available patient-calling team and make patient calls when needed to resolve billing or insurance issues.
Offer practical guidance to junior team members while remaining personally responsible for an assigned AR workload.
Required qualifications
Minimum 3–4 years of direct AR follow-up and denial-resolution experience. General billing, charge-entry, payment-posting, or supervisory experience alone does not meet this requirement.
Strong ability to interpret EOBs, ERAs, claim adjustment reason codes, and remittance remark codes.
Demonstrated experience submitting corrected claims, reconsiderations, and appeals.
Working familiarity with Availity, Cigna, UnitedHealthcare, and other commercial insurance portals.
Understanding of CPT codes, ICD-10 codes, modifiers, eligibility-related denials, authorizations, coordination of benefits, and payer billing requirements.
Confident insurance-calling skills and professional patient communication.
Ability to independently investigate a claim, explain the issue, take corrective action, and follow it through to resolution.
Practical assessment
Shortlisted candidates will review a de-identified claim and EOB/ERA, identify the denial or payment issue, explain the appropriate corrective action, and demonstrate how they would document and pursue resolution.
To apply: Submit your résumé and briefly describe your direct AR experience, payer portals used, and two examples of denials or unpaid claims you personally resolved.

Work arrangement
No