Accounts Receivable Specialist

Alliance Health System; Matawan (NJ); Remote; USD 28,000 - 41,000; Full time

Benefits offered by this job

401(k) matching

Medical, Dental & Vision

Paid Time Off

Sick Time

Paid Holidays

Job summary

Alliance Health System is seeking an Accounts Receivable Specialist to manage denial resolutions and maximize reimbursements. This role emphasizes meticulous billing practices, timely follow-ups with insurance payers, and collaboration with a diverse team to ensure clean claims and reduced denials.

You will handle out-of-network processes, stay compliant with healthcare regulations, and work remotely with the RCM: Collections department to optimize revenue.

Qualifications

• Denial management and resolution of claim denials.
• Experience with follow-up with insurance providers to maximize reimbursements.
• Strong organizational skills and attention to detail in accounts receivable processes.
• Excellent written and verbal communication with internal and external stakeholders.
• Bilingual Spanish is a plus.

Responsibilities

• Investigate and resolve claim denials by appealing, resubmitting, or correcting as needed.
• Follow up regularly with insurance companies and patients to ensure timely payments on balances.
• Maintain compliance with industry regulations and billing practices.

Skills

Denial Management

Follow-Up

Compliance

Organizational Skills

Independence & Collaboration

Communication Skills

Bilingual Spanish

Tools

Excel

Google Sheets

Payer Portals

Job description

Accounts Receivable Specialist

Department: RCM: Collections

Location: Headquarters - Matawan

Compensation: $20.00 - $30.00 / hour

Description

Location: REMOTE

Entity: Alliance Health System

Reports To: Director of Collections

*Out of Network experience required*

As a Medical Billing & Collections Specialist, you'll play a key role in helping our healthcare providers focus on what matters most—caring for patients—by ensuring claims are processed accurately, denials are resolved efficiently, and reimbursements are maximized

In this role, you'll investigate and resolve denied or underpaid claims, follow up with insurance companies and patients, and help keep revenue cycle operations running smoothly. You'll collaborate with a team that believes every challenge is an opportunity to improve, every process can be optimized, and every team member contributes to better patient outcomes

Summary of Responsibilities

• Denial Management: Investigate and resolve claim denials by appealing, resubmitting, or making necessary corrections.
• Follow-Up: Conduct regular follow-ups with insurance companies and patients to ensure timely payment of outstanding balances
• Compliance: Stay updated on industry regulations and compliance requirements to ensure adherence in billing practices.

Basic Requirements

• Claim Resolution and Reimbursement: Demonstrate strong desire and commitment to resolving medical claims and effectively collecting insurance reimbursements
• Organizational Skills: Must possess excellent organizational skills with thorough attention to detail in handling accounts receivable processes.
• Independence and Collaboration: Ability to work independently and collaboratively within a group, fostering a team-oriented and efficient work environment.
• Communication Skills: Exceptional written and verbal communication skills are essential, showcasing the ability to interact professionally and effectively with both internal and external stakeholders

Experience Requirements

• Medical Billing/Collections Professional: Proven experience in resolving denied/underpaid claims and conducting thorough follow-ups with insurance providers to maximize reimbursements.
• Diverse Responsibilities: Extensive experience in various aspects of medical billing and collections, including but not limited to claim submissions, attorney follow-ups, and other duties relevant to the field.
• Specialized Expertise: Prior experience in Conservative Therapy (Physical Therapy, Occupational Therapy, and Chiropractic), Medical (Physical Medicine and Rehabilitation, with expertise in Pain Management, Orthopedic, and Vascular disciplines), or Patient Accounts (Self Pay) is preferred.
• Excel/Google Sheets: Demonstrated proficiency in utilizing Excel and Google Sheets for data analysis and reporting purposes.
• Out of Network Experience: Proven track record of handling Out of Network billing processes effectively.
• Payer Portals: Familiarity with various Payer Portals for streamlined communication and efficient claims processing.
• Insurance Knowledge: Extensive experience with all Major Medical Insurance Providers, Work Comp, and Motor Vehicle claims is preferred.
• Bilingual Skills: Fluency in Spanish is a plus.

Job Type

• Full-Time
• Monday-Friday
• Remote

Benefits

• 401(k) matching
• Medical, Dental & Vision
• Paid Time Off
• Sick Time
• Paid Holidays

Background Check Requirement: Employment is contingent upon the successful completion of a background check, which may include verification of employment history, education, criminal records, and other relevant information as permitted by law.