Senior ABA Revenue Cycle / Accounts Receivable Specialist

OpsArmy; Puerto Bogotá; À distance; COP 156 459 000 - 223 513 000; Plein temps

Résumé du poste

OpsArmy is seeking a Senior ABA Revenue Cycle / AR Specialist to lead hands-on management of healthcare RCM, insurance claims, and denial resolution. This remote role requires independence in handling high-volume claims, payer follow-ups, and AR aging with ABA-specific billing knowledge.

You will collaborate with the RCM team to optimize billing processes, reduce denials, and implement workflow improvements. Experience with ABA billing rules and direct care supervision is highly valued.

Qualifications

• 5+ years in healthcare RCM & AR.
• Experience with medical billing, insurance claims and denial management.
• Direct ABA billing experience is highly preferred.
• Knowledge of denial root-cause analysis and corrective actions.
• Familiarity with ABA billing rules, especially concurrent supervision and RBT restrictions.
• Ability to independently manage high-volume AR and resolve outstanding claims.
• Strong analytical, organizational and communication skills.

Responsabilités

• Manage day-to-day revenue cycle management and AR operations.
• Monitor denied, outstanding, and aging claims; investigate statuses.
• Follow up with payers for payment issues and discrepancies.
• Identify recurring denial patterns and implement corrective actions.
• Ensure ABA billing compliance and payer-specific requirements.
• Suggest workflow improvements and automation to increase efficiency.

Connaissances

RCM & AR

Medical billing

Insurance claims

Denial management

Payer follow-ups

ABA billing experience

Denial root-cause analysis

Billing rules ABA

Analytical skills

Independent work

Outils

Microsoft Excel

Google Sheets

RCM systems

Billing software

Payer portals

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.