Accounts Receivable Specialist (remote)

United Wound Healing; Roanoke (VA); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading medical practice seeks an AR Specialist to enhance cash flow and manage receivables effectively. This remote position involves troubleshooting claims and collaborating with insurance payors, requiring profound expertise in revenue cycle management. Ideal candidates will have strong communication skills, attention to detail, and a commitment to quality care in wound management.

Benefits

Medical, dental, vision coverage

Paid time off and holidays

401(k) match

Positive work culture

Qualifications

• 3+ years of medical billing and accounts receivable experience.
• Advanced expertise in revenue cycle management and claims processing.
• Knowledge of ICD-10, CPT, and HCPCS.

Responsibilities

• Investigate root cause of unresolved claims and troubleshoot claim data.
• Make outbound calls for claim resolution and document activities.
• Collaborate with business offices to identify potential denial trends.

Skills

Critical thinking

Problem-solving

Attention to detail

Strong verbal communication

Customer service skills

Education

CPB or CPC certification

Tools

MS Office

Job description

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Must be located in one of the following states: WA, OR, ID, UT, TX, AZ, VA, FL, NC, GA, PA.

Our mission to change wound care and improve the lives of others isn't easy, but it's worth it! One in ten residents in a skilled nursing facility will develop a skin condition requiring expert medical care. We believe that every person deserves the very best wound care. Building and leading wound care teams is how we do it! Our wound care providers bring education and encouragement to the people who take care of our patients 24/7. When they get better at their jobs, our patient's wounds heal faster and that is our goal!

United Wound Healing's AR Specialist is a critical role to our financial success within our medical practice. This Specialist will assist in improving cash flow and participate in managing the overall health of the company's receivables by minimizing lost revenue and ensuring paid claims. The role is responsible for effective collection on unresolved claims and will include daily accounts receivable resolution from insurance carriers in multiple states (including WA, OR, ID, and UT). The ideal candidate will have advanced expertise in the revenue cycle management process and insurance claims processing cycle.

Main Responsibilities (may include but are not limited to):

1. Thoroughly investigate the root cause of unresolved claims (including denials, underpayments, or delayed payment).
2. Troubleshoot and correct claim data to ensure clean claim processing.
3. Dispute inaccurate denials with insurance payors.
4. Submit written appeals to insurance payors when applicable and ensure timely follow-up regarding status.
5. Supply supporting documentation for unresolved claims as needed.
6. Identify payor changes, verify eligibility, and accurately update COB on account.
7. Accurately identify the correct insurance payor(s).

Navigate insurance payor sites.

Make outbound calls to collaborate with insurance payors for claim resolution.

1. Collaborate with partner facility's business office.
2. Identify and communicate potential denial trends, coding issues, etc.
3. Perform account reconciliation as needed.
4. Identify and review overpayments, complete refund request paperwork, and/or process insurance takebacks via ERAs.
5. Follow-up and resolve worklist items assigned.
6. Provide detailed documentation surrounding work performed on each individual account.
7. Answer incoming calls within the business office and provide professional assistance.
8. Complete daily AR log and submit to Supervisor.
9. Meet productivity standards as set by the department.

Preferred but not required certifications: CPB, CPC (or CPC-A).

Requirements include:

• 3+ years medical billing and accounts receivable experience.
• Advanced expertise with revenue cycle management process and insurance claims processing cycle.
• Ability to read and understand EOBs.
• Strong understanding of insurance denials and unresolved claims resolution.
• Knowledge of ICD-10, CPT, and HCPCS.
• Understand CMS-1500 claim format.
• Critical thinking and strong problem-solving skills.
• Skilled in MS Office: Outlook, Excel (intermediate), and Word.
• Strong work ethic with high attention to detail.
• Excellent organization and time management skills.
• Ability to prioritize workload and manage time-sensitive situations with urgency.
• Strong verbal and written communication skills, customer service skills.
• Dependable, able to work independently.
• Trustworthy, honest, positive, professional attitude.
• Adaptability to changing procedures and growing work environment.

Location: Remote, based in WA.

Compensation: $24.00 - $27.00 hourly, DOE and location.

This position is classified as: Hourly, Non-Exempt; Full-Time.

Hours: Monday through Friday, 7:30am - 4:00pm PST, occasional overtime.

• Work remotely from a home office.
• Benefits include medical/dental/vision/RX coverage, employer-sponsored life, AD&D, disability insurance, voluntary supplemental insurance, paid time off, holidays, 401(k) match, and a positive work culture.

We are a drug-free workplace. All offers contingent upon drug screen and background check. EEO.