Accounts Receivable Specialist

Private Advertiser; Quezon City; Presencial; PHP 350 000 - 520 000; Tempo integral

Resumo da oferta

Private Advertiser is seeking an Accounts Receivable Specialist to join the Revenue Cycle Management team, handling the full AR lifecycle from claim submission to payment posting and denial resolution within a healthcare setting.

The role collaborates with billing, coding, and clinical staff to maximize collections, reduce aging, and ensure compliance with HIPAA and payer policies while maintaining accurate AR records in the practice management system.

Qualificações

• College graduate with related field or equivalent combination.
• Minimum 2 years in medical billing and accounts receivable.
• Working knowledge of ICD-10, CPT, and HCPCS coding.
• Familiarity with commercial, Medicare and Medicaid billing requirements.
• Strong understanding of revenue cycle from patient registration to collections.
• Proficiency with Microsoft Office Suite (Excel, Word, Outlook).

Responsabilidades

• Monitor AR aging reports and resolve outstanding balances.
• Submit clean claims to insurers in a timely manner.
• Proactively follow-up on unpaid, underpaid, and denied claims.
• Review EOBs/ERAs for accuracy and appeal where needed.
• Draft and submit appeals with supporting documentation.
• Post payments accurately and reconcile daily deposits.
• Coordinate with front office on eligibility and patient responsibility.
• Maintain compliant AR documentation and assist month-end close.

Conhecimentos

Attention to detail

Communication

Time management

Formação académica

College graduate in any related field

Ferramentas

EyeMD EMR

OpenPM

ModMed EMA

NextGen/NextTech

Payer portals (Availity, Navicure/Waystar, Change Healthcare)

Microsoft Excel

Descrição da oferta de emprego

JOB OVERVIEW

The Accounts Receivable Specialist is a key member of the Revenue Cycle Management team responsible for managing the full AR lifecycle — from claim submission and payer follow-up through payment posting and denial resolution. This role works closely with billing, coding, and clinical staff to maximize collections and minimize aging.

KEY RESPONSIBILITIES

Claims Management & Follow-Up

• Monitor and work accounts receivable aging reports to identify and resolve outstanding balances




• Submit clean claims to commercial insurers, Medicare, Medicaid, and managed care plans in a timely manner




• Conduct proactive payer follow-up on unpaid, underpaid, and denied claims via phone, payer portals, and ERAs

Denials & Appeals

• Review and analyze Explanation of Benefits and Electronic Remittance Advice for accuracy




• Draft and submit appeals for denied or partially denied claims with appropriate supporting documentation




• Understand common ophthalmology-specific denial reasons and apply appropriate resolution strategies

Payment Posting & Reconciliation

• Post insurance and patient payments accurately in the practice management system




• Reconcile daily deposits and identify posting discrepancies




• Process adjustments, write-offs, and balance transfers in accordance with payer contracts and practice policies

Patient Billing & Communication

• Research and resolve patient billing inquiries




• Coordinate with front office staff to verify benefits, eligibility, and patient responsibility prior to and following services




• Generate and review patient statements; initiate collection processes as needed

Reporting & Compliance

• Maintain accurate and complete documentation of all AR activity, payer contacts, and claim status in the PM system




• Adhere to HIPAA regulations and maintain strict patient confidentiality at all times




• Support month-end close processes and contribute to AR metric reporting




• Stay current with payer policy updates, CMS guidelines, and ophthalmology-specific coding changes

QUALIFICATIONS

• College graduate of any related field or equivalent combination of education, training and experience




• Minimum 2 years of experience in medical billing and accounts receivable in a healthcare setting




• Working knowledge of ICD-10, CPT, and HCPCS coding principles




• Familiarity with commercial insurance, Medicare, and Medicaid billing requirements




• Strong understanding of the revenue cycle workflow from patient registration through collections




• Proficiency with Microsoft Office Suite (Excel, Word, Outlook)




• Excellent attention to detail, organizational skills, and ability to manage a high-volume workload




• Strong verbal and written communication skills for patient and payer interactions




• Must have a stable and reliable internet connection

Preferred

• Experience in ophthalmology billing, including knowledge of ophthalmic procedures, ASC billing, and vision vs. medical benefit determination




• Familiarity with ophthalmology-specific payers and managed vision plans (VSP, EyeMed, Spectera, Davis Vision)




• Certification such as CPC, CPMA, CPAR, or CRCE

SYSTEMS & TECHNOLOGY

Candidates with direct experience in one or more of the following platforms are strongly encouraged to apply:

EMR / Practice Management Systems:

• EyeMD EMR — ophthalmology-specific EMR platform




• OpenPM — practice management and billing platform




• ModMed (EMA) — cloud-based EHR with integrated billing and scheduling




• NextGen / NextTech — enterprise EHR and revenue cycle management suite

Additional Tools:

• Payer portals (Availity, Navicure/Waystar, Change Healthcare, etc.)




• Clearinghouse platforms for claim submission and ERA retrieval




• Microsoft Excel for AR reporting and data analysis