Accounts Receivable Specialist

EmpowerMe Wellness; Northern (KY); Hybrid; USD 42,000 - 62,000; Full time

Job summary

EmpowerMe Wellness is seeking an Accounts Receivable Specialist in Northern Kentucky to manage rejected, denied, and outstanding insurance claims, ensuring billing accuracy. You will research issues, communicate with payers, and support credentialing to keep claims moving smoothly.

The role demands strong attention to detail, healthcare billing knowledge, and the ability to collaborate cross-functionally with verification and Billing Supervisor teams.

Qualifications

• Bachelor’s or Associate degree with healthcare office experience.
• Detail-oriented, data-driven with strong communication.
• Experience with medical billing and credentialing preferred.

Responsibilities

• Complete accounts receivable collections and follow-ups to expedite insurance payments for assigned claims.
• Contact insurance companies via phone, mail, or clearinghouse correspondence to address inquiries and update information.
• Communicate claim issues related to patient benefits to the verification team and field staff for resolution.
• Proactively collaborate with third-party payers to resolve claims processing issues and stay updated on plan requirements.
• Assist in streamlining policies and procedures for more effective operations of third-party carriers, reporting to Billing Supervisor.
• Prepare and assist with monthly reports focusing on key indicators, payer issues, and unit performance to improve metrics (DSO).
• Process appeals by gathering required documentation, resubmitting claims, and following up promptly to track resolution.
• Maintain compliance with HIPAA and CMS guidelines in all interactions and documentation.

Skills

Accounts receivable

Insurance claims

Data analysis

Communication

Multitasking

Customer service

HIPAA compliance

Education

Bachelor’s or Associate degree

High School diploma/GED with 5 years experience

Tools

EMR systems

Medical billing software

Microsoft Excel

Job description

Overview

Position Summary: As an Accounts Receivable Specialist, you will manage tasks related to rejected, denied, and outstanding insurance claims, ensuring accuracy throughout the billing process. This includes addressing issues such as missing or incomplete documentation, delays in claim processing due to submission requirements, and credentialing concerns. Success in this role depends on thorough research, timely communication, and proactive problem-solving.

Responsibilities

Key Responsibilities: While this list includes primary duties, additional tasks may be assigned. Accommodations can be made for individuals with disabilities to perform essential functions.

• Complete accounts receivable collections and follow-ups to expedite insurance payments for assigned claims.
• Contact insurance companies via phone, mail, or clearinghouse correspondence to address account inquiries and update information.
• Communicate claim issues related to patient benefits to the verification team and field staff for resolution.
• Proactively collaborate with third-party payers to resolve claims processing issues, improve communication, and stay updated on changes to plan requirements.
• Assist in streamlining policies and procedures for more effective and efficient operations of third-party carriers, providing updates to the Billing Supervisor as needed.
• Prepare and assist with monthly reports, focusing on key indicators, payer issues, and unit performance, with a goal to improve metrics such as DSO (Days Sales Outstanding).
• Process appeals by gathering required documentation, resubmitting claims, and following up promptly to track resolution.
• Maintain compliance with HIPAA and CMS guidelines in all interactions and documentation.

Qualifications

Qualifications & Experience: To succeed in this role, candidates must meet the following qualifications:

• Education: Bachelor’s degree or Associate’s degree with 3 years of professional office experience, or High School diploma/GED with 5 years of experience (healthcare setting preferred).
• Strong attention to detail and a thorough, results-oriented work ethic.
• Self-motivated, with a professional curiosity to learn and recommend innovative solutions.
• Excellent communication and interpersonal skills.
• Ability to adapt in a fast-paced environment, remain calm under pressure, and multitask effectively.
• Commitment to providing exceptional customer service, maintaining professionalism, and supporting team collaboration.
• Knowledge of insurance benefit coordination, medical billing, and credentialing.
• Ability to use independent judgment to handle confidential information responsibly.
• Experience analyzing and interpreting data to prepare actionable reports.

Computer Skills

Proficiency in Microsoft Office applications (Outlook, Excel, Word, and Publisher). Experience with Internet browsers, including Chrome, Edge, and Firefox. Familiarity with EMR systems, clearinghouses, and medical billing software.

Work Environment & Physical Demands

This role requires frequent communication by phone and email. Physical requirements include sitting, standing, walking, stooping, and using hands for various tasks. Vision abilities needed include close, distance, and peripheral vision, depth perception, and focus adjustment.