AR & Billing Specialist – Remote, Growth Path

Phothera Phototherapy; Providence (RI); Remote; USD 39,000 - 44,000; Full time

Job summary

Phothera Phototherapy, a Madison Industries company, is seeking a proactive Medical Billing & Follow-Up Specialist to join its Revenue Cycle team in a role focused on AR follow-up and resolving unpaid or delayed DME claims. The position supports a transition to a new revenue cycle platform and aims to accelerate cash flow.

You will own follow-up, interpret EOBs/ERAs, research payer policies, validate documentation, and submit appeals when needed.

Qualifications

• 2+ years of experience in medical billing, accounts receivable, reimbursement, or revenue cycle management.
• Hands-on experience with professional/physician billing and CMS-1500 claims.
• Experience investigating and resolving unpaid, underpaid, rejected, and denied claims.
• Strong understanding of payer follow-up, EOBs/ERAs, claim corrections, and resubmissions.
• Experience working with Medicare, Medicaid, and commercial insurance payers.
• Working knowledge of CPT, HCPCS, modifiers, and medical necessity requirements.
• Ability to research claim issues, identify root causes, and independently determine appropriate next steps.
• Strong organizational skills with the ability to manage a high-volume claim inventory and follow issues through resolution.
• Comfortable working independently in a remote environment and adapting to evolving processes and priorities.

Responsibilities

• Track and resolve unpaid, underpaid, or delayed DME claims
• Submit and follow up on Medicare, Medicaid, Commercial, and VA claims
• Interpret EOBs and ERAs and apply payments accurately
• Research payer policies, LCDs and NCDs, and coverage requirements
• Validate documentation including CMNs, prescriptions, proof of delivery, and prior authorizations
• Submit appeals when necessary and monitor outcomes
• Identify systemic issues and recommend process improvements
• Maintain detailed, compliant documentation within the billing system

Skills

Medical billing

Accounts receivable

Revenue cycle

Payer follow-up

EOBs/ERAs

CMS-1500

Remote work

Process improvement

Job description

Phothera Phototherapy, a Madison Industries company, is seeking a proactive Medical Billing & Follow-Up Specialist to join its Revenue Cycle team in a role focused on AR follow-up and resolving unpaid or delayed DME claims. The position supports a transition to a new revenue cycle platform and aims to accelerate cash flow.

You will own follow-up, interpret EOBs/ERAs, research payer policies, validate documentation, and submit appeals when needed.