Accounts Receivable Specialist (REMOTE)

CommUnityCare Health Centers; Austin (TX); Remote; USD 45,000 - 70,000; Full time

Job summary

Ein etabliertes Unternehmen im Gesundheitswesen sucht einen Accounts Receivable Specialist, um das Revenue Cycle Management-Team zu unterstützen. In dieser Rolle sind Sie verantwortlich für die Nachverfolgung und Lösung von ausstehenden Versicherungsansprüchen. Sie werden eng mit verschiedenen Abteilungen zusammenarbeiten, um sicherzustellen, dass alle Zahlungen korrekt verarbeitet werden. Wenn Sie eine Leidenschaft für den Gesundheitssektor haben und über ausgezeichnete Kommunikationsfähigkeiten verfügen, könnte dies die perfekte Gelegenheit für Sie sein, in einem dynamischen Umfeld zu arbeiten, das sich der Verbesserung der Patientenversorgung widmet.

Qualifications

• Mindestens 3 Jahre Erfahrung im Management von Forderungen.
• Erfahrung mit medizinischer Terminologie und Abrechnungscodes.

Responsibilities

• Nachverfolgung von ausstehenden medizinischen Forderungen bei Versicherern.
• Erstellung und Nachverfolgung von Einsprüchen bei Ablehnungen.

Skills

Kundenservicefähigkeiten

Detailgenauigkeit

Problemlösungsfähigkeiten

Kommunikationsfähigkeiten

Education

High School Diplom oder GED

Tools

Microsoft Excel

Microsoft Office

Medizinische Verwaltungssoftware

Elektronische Patientenakten

Job description

Join to apply for the Accounts Receivable Specialist (REMOTE) role at CommUnityCare Health Centers

This role reports to the Accounts Receivable Supervisor and supports the CommunityCare Revenue Cycle Management (RCM) team by following up on and resolving outstanding insurance claims. The main goal is to investigate and resolve claims submitted for payment, creating detailed notes on their current status.

Please note: We currently hire candidates exclusively from the following states. Applicants outside these states will not be considered:

• Arizona
• Connecticut
• Florida
• Georgia
• Michigan
• North Carolina
• Ohio
• Texas

Essential Functions

1. Follow up daily with insurance carriers on outstanding medical claims, especially denials or benefit changes.
2. Maintain accurate aging reports of accounts, including AR analysis and follow-up.
3. Stay informed on billing and medical policies for all payers.
4. Understand reimbursement processes for In and Out of Network services.
5. Create and follow up on appeals for denials or incorrect payments.
6. Review and resolve complex denials and tasks, including refunds and disputes.
7. Collaborate across RCM departments to resolve claim payment issues.
8. Ensure compliance with all policies, procedures, and organizational values.
9. Assist the AR Supervisor in reviewing and resolving open accounts.
10. Perform other duties as assigned.

Knowledge, Skills, and Abilities

• Excellent relationship-building and customer service skills.
• Proficiency with computers for data entry and research.
• High attention to detail, accuracy, and ability to multitask.
• Strong problem-solving skills.
• Professional and kind communication with staff, payers, patients, and families.
• Leadership by example, ensuring compliance with regulations and policies.
• Report issues promptly to supervisors.
• Maintain regular attendance and manage high volumes of work independently.
• Monitor claims processing steps effectively.

Minimum Education

• High School Diploma or GED

Minimum Experience

• At least 3 years managing Accounts Receivable and following up with payers.
• At least 1 year communicating effectively with insurance payers and internal teams.
• 3 years working with medical terminology, ICD10, CPT, HCPCS coding, and HIPAA.
• 2 years with data processing, Excel, Microsoft Office, medical practice management software, and electronic medical records.
• 3 years working with various insurance payers and understanding their reimbursement policies.
• 3 years handling complex insurance issues, including correct payer assignment, EOB adjustments, and refunds.

Additional Information

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Accounting/Auditing and Finance
• Industries: Hospitals and Health Care