Healthcare AR Specialist: Denials & Reimbursement Expert

Landmark Anesthesia Medical Group; Brea (CA); On-site; USD 52,000 - 64,000; Full time

Job summary

Medical Billing Company in California is seeking an experienced Accounts Receivable (AR) Specialist to join our healthcare billing team. The ideal candidate will handle insurance follow-up, reimbursement analysis, denial resolution, and payer appeals, maintaining accurate account documentation and timely follow-up.

The successful candidate will review accounts, analyze payer adjudications, prepare appeals, and work with Medicare, Medi-Cal, commercial insurance, and Workers’ Compensation payers.

Qualifications

• Minimum of 2–3 years of healthcare Accounts Receivable experience.
• Experience with insurance follow-up, reimbursement analysis, denial resolution, and payer appeals.
• Working knowledge of Medicare, Medi-Cal, commercial insurance, and Workers’ Compensation reimbursement.
• Proficiency with Microsoft Excel and healthcare billing software.

Responsibilities

• Review insurance claims to verify payment accuracy, reimbursement methodology, and contractual compliance.
• Follow up on unpaid, underpaid, partially paid, and denied claims.
• Research payer policies, reimbursement methodologies, contractual provisions, and coverage guidelines to support claim resolution.
• Prepare appeals, reconsiderations, corrected claims, and written payer correspondence supported by reimbursement analysis and appropriate documentation.
• Review Explanation of Benefits (EOBs), Electronic Remittance Advice (ERA), and payer correspondence to identify reimbursement issues and determine appropriate follow-up actions.
• Work with Medicare, Medi-Cal, commercial insurance, and Workers’ Compensation payers.
• Identify reimbursement trends, recurring denial patterns, and systemic issues requiring escalation or process improvement.
• Maintain complete, accurate, and timely account documentation and follow-up notes.
• Prioritize accounts based on aging reports, timely filing requirements, and payer deadlines.
• Collaborate with billing, coding, and management to resolve reimbursement issues and improve claim resolution.

Skills

Healthcare AR experience

Insurance follow-up

Denial resolution

Payer appeals

Attention to detail

Tools

Microsoft Excel

Healthcare billing software

Job description

Medical Billing Company in California is seeking an experienced Accounts Receivable (AR) Specialist to join our healthcare billing team. The ideal candidate will handle insurance follow-up, reimbursement analysis, denial resolution, and payer appeals, maintaining accurate account documentation and timely follow-up.

The successful candidate will review accounts, analyze payer adjudications, prepare appeals, and work with Medicare, Medi-Cal, commercial insurance, and Workers’ Compensation payers.