Senior ABA Revenue Cycle / Accounts Receivable Specialist

OpsArmy; Bogotá; À distance; COP 253 141 000 - 348 068 000; Plein temps

Résumé du poste

OpsArmy is seeking a Senior ABA Revenue Cycle / AR Specialist to lead high-volume RCM operations, claims management, and denial resolution in a remote role with US hours. The ideal candidate will bring hands-on expertise in ABA billing, payer follow-ups, and AR collection, independently driving process improvements while maintaining accuracy and compliance across payer policies.

You will own end-to-end billing cycles, document claim activities, and work with the RCM team to reduce denials and

Qualifications

• Substantial healthcare RCM and AR experience.
• Proven medical billing, claims handling, denial management, and payer follow-ups.
• Direct ABA billing experience highly preferred.
• Strong knowledge of denials, corrected claims, resubmissions, collections.
• Familiarity with ABA billing rules and concurrent supervision restrictions.
• Ability to manage high-volume AR independently.
• Strong analytical, organizational, and communication skills.
• Self-motivated with minimal supervision.

Responsabilités

• Manage day-to-day RCM and high-volume AR operations.
• Monitor denied, outstanding, and aging claims.
• Investigate claim statuses through payer portals and billing systems.
• Conduct payer follow-ups, collections, and escalations.
• Prioritize claims based on aging, urgency, financial impact, and deadlines.
• Maintain accurate documentation of claim activities and resolutions.
• Investigate denied and rejected claims and identify root causes.
• Correct billing errors and submit corrected or resubmitted claims.
• Follow up with insurance companies regarding payment issues and discrepancies.
• Identify recurring denial patterns and implement corrective actions.
• Reduce preventable denials and outstanding AR balances.
• Understand ABA-specific billing requirements and payer policies.
• Navigate concurrent billing restrictions involving supervision services and direct RBT care.
• Identify billing conflicts involving service dates, times, provider documentation, and billing combinations.
• Ensure compliance with payer-specific reimbursement and billing requirements.
• Identify recurring denials, billing discrepancies, and workflow bottlenecks.
• Recommend solutions to prevent repeated billing issues.
• Improve billing workflows, internal controls, and operational processes.
• Identify opportunities for automation and improved RCM efficiency.
• Coordinate with the existing RCM team and distribute workloads effectively.
• Manage responsibilities independently with minimal supervision.
• Communicate claim issues, findings, and progress proactively.
• Take ownership of substantial billing and AR workloads while maintaining accuracy and productivity.

Connaissances

RCM expertise

Denial resolution

ABA billing

Analytical thinking

Independent work

Communication skills

Outils

Excel

Billing systems

Payer portals

Workflow automation

RCM software

Slack

Claims management tools

Description du poste

Senior ABA Revenue Cycle / Accounts Receivable Specialist

Remote | US Hours

Job Overview

A senior-level, hands-on position responsible for managing healthcare Revenue Cycle Management (RCM), insurance claims, denial resolution, and accounts receivable (AR). Direct ABA billing experience is highly preferred.

The ideal candidate must independently manage high-volume claims, investigate outstanding balances, resolve denials, conduct payer follow-ups, and improve billing processes with minimal supervision.

Key Responsibilities

1. Revenue Cycle Management & Accounts Receivable

• Manage day-to-day RCM and high-volume AR operations.
• Monitor denied, outstanding, and aging claims.
• Investigate claim statuses through payer portals and billing systems.
• Conduct payer follow-ups, collections, and escalations.
• Prioritize claims based on aging, urgency, financial impact, and deadlines.
• Maintain accurate documentation of claim activities and resolutions.

2. Claims Investigation & Denial Management

• Investigate denied and rejected claims and identify root causes.
• Correct billing errors and submit corrected or resubmitted claims.
• Follow up with insurance companies regarding payment issues and discrepancies.
• Identify recurring denial patterns and implement corrective actions.
• Reduce preventable denials and outstanding AR balances.

3. ABA Billing & Payer Compliance

• Understand ABA-specific billing requirements and payer policies.
• Navigate concurrent billing restrictions involving supervision services and direct RBT care.
• Identify billing conflicts involving service dates, times, provider documentation, and billing combinations.
• Ensure compliance with payer-specific reimbursement and billing requirements.

4. Process Improvement & Automation

• Identify recurring denials, billing discrepancies, and workflow bottlenecks.
• Recommend solutions to prevent repeated billing issues.
• Improve billing workflows, internal controls, and operational processes.
• Identify opportunities for automation and improved RCM efficiency.

5. Team Collaboration & Ownership

• Coordinate with the existing RCM team and distribute workloads effectively.
• Manage responsibilities independently with minimal supervision.
• Communicate claim issues, findings, and progress proactively.
• Take ownership of substantial billing and AR workloads while maintaining accuracy and productivity.

Qualifications & Requirements

• Strong hands-on healthcare RCM and AR experience.
• Proven experience in medical billing, insurance claims, denial management, and payer follow-ups.
• Direct ABA billing experience highly preferred.
• Strong understanding of claim denials, corrected claims, resubmissions, collections, and denial root-cause analysis.
• Knowledge of insurance billing requirements and reimbursement policies.
• Familiarity with ABA-specific billing rules, particularly concurrent supervision and RBT direct care restrictions.
• Ability to independently manage high-volume AR and resolve outstanding claims.
• Strong analytical, problem-solving, organizational, and communication skills.
• Ability to work independently with minimal supervision.

Preferred Technical Skills

• Candid – particularly for billing, claims management, denial resolution, and AR workflows.
• Insurance payer portals and claim-status systems.
• Claims management and denial tracking tools.
• Microsoft Excel or Google Sheets.
• Slack or similar communication platforms.
• Healthcare billing and RCM systems.
• Workflow automation and process improvement tools.

Ideal Candidate Profile

A proactive, analytical, and solutions-oriented senior RCM professional who:

• Takes initiative in identifying and addressing outstanding claims.
• Owns claims from investigation through final resolution.
• Understands ABA billing nuances and payer-specific restrictions.
• Identifies recurring issues and develops long-term solutions.
• Prevents billing errors before claims are submitted.
• Is comfortable using technology and automation.
• Works collaboratively while maintaining independent ownership.

Hiring Priority

• Immediate need: At least 1 qualified specialist.
• Potential additional headcount: A second specialist may be considered depending on workload and operational requirements.

Important Candidate Screening Consideration:

Candidates must have substantial healthcare RCM, claims management, denial resolution, and AR experience. Those whose backgrounds are limited to basic medical billing, data entry, or medical records retrieval without hands-on claims and AR ownership are not suitable.