Healthcare AR Specialist: Denials & Reconciliation

Arallergy; Louisville (KY); On-site; USD 25,000 - 39,000; Full time

Job summary

Family Allergy & Asthma in Louisville, KY is seeking a Medical Accounts Receivable Specialist. The role handles Medicare, Medicaid, Dual, Commercial, Managed Care and Advantage claims across multiple states and collaborates with payer portals to recover denied or pending payments.

You will review payer policies, submit corrected claims, document research in IMS, and coordinate with departments to improve cash flow. Requires 2+ years AR experience, EMR experience, and strong English communication.

Qualifications

• 2+ years of Accounts Receivable experience, preferably in a healthcare setting.
• 2+ years of EMR platform experience.
• Experience working with multiple carrier types such as Medicare, Medicaid, Dual, Commercial, Managed Care and Advantage plans in multiple states.

Responsibilities

• Understands and has experience with multiple carrier types in multiple states.
• Research and investigate denied or no response claims to confirm reason for denial and best method of recovery.
• Reviews payer policies and guidelines to support reconsiderations and appeals where needed.
• Identifies trends and notifies leads and manager immediately to establish plan of action.
• Submits corrected claims, reconsiderations and appeals via portal, fax or secure email using mail as last resort.
• Thoroughly documents research done and action taken on each claim in IMS.
• Communicates with other departments via shared spreadsheets and conducts regular follow-ups on cross communication.
• Other relevant duties as assigned by department manager.

Skills

English fluency

Accounts receivable

Communication skills

Education

High School Diploma or equivalent

Tools

EMR systems

Job description

Family Allergy & Asthma in Louisville, KY is seeking a Medical Accounts Receivable Specialist. The role handles Medicare, Medicaid, Dual, Commercial, Managed Care and Advantage claims across multiple states and collaborates with payer portals to recover denied or pending payments.

You will review payer policies, submit corrected claims, document research in IMS, and coordinate with departments to improve cash flow. Requires 2+ years AR experience, EMR experience, and strong English communication.