Insurance AR Leader: Denials & Reimbursement Strategy

PF Concepts; Fairfield (NJ); On-site; USD 90,000 - 120,000; Full time

Job summary

PF Concepts is seeking an Insurance AR Manager in New Jersey to provide strategic direction for the accounts receivable function in healthcare. You will lead teams, set KPIs, and guide complex claim issues while ensuring compliance with payer regulations and internal policies.

The role requires strong leadership, deep expertise in reimbursement, and proficiency with EMR, clearinghouse, and billing systems. Travel for onsite training and client meetings is expected.

Qualifications

• Leadership and coaching skills are essential.
• Strong understanding of healthcare reimbursement, billing regulations, and denial management is required.
• Ability to analyze financial and operational data, identify trends, and implement improvements.
• Excellent communication and conflict resolution skills for internal staff and external payer/client interactions.
• Proficiency in EMR, clearinghouse platforms, and medical billing systems is necessary.

Responsibilities

• Supervise Team Leads and Specialists and ensure accountability for performance.
• Develop departmental goals and KPIs aligned with company objectives.
• Provide guidance on complex claim issues beyond Team Lead authority.
• Oversee daily operations of insurance AR follow-up, denial resolution, and appeals.
• Monitor reimbursement turnaround times and payer trends; drive corrective action as needed.
• Approve staffing allocations to balance workloads across teams.
• Ensure compliance with payer requirements and internal policies.
• Oversee quality assurance reviews on claims and documentation; participate in audits.

Skills

Leadership

Healthcare reimbursement

Data analysis

Communication

Billing systems

Education

Associate's degree in a related field

CPB/CCS/CRCR certification preferred

Tools

EMR systems

Clearinghouse platforms

Medical billing systems

Job description

PF Concepts is seeking an Insurance AR Manager in New Jersey to provide strategic direction for the accounts receivable function in healthcare. You will lead teams, set KPIs, and guide complex claim issues while ensuring compliance with payer regulations and internal policies.

The role requires strong leadership, deep expertise in reimbursement, and proficiency with EMR, clearinghouse, and billing systems. Travel for onsite training and client meetings is expected.