Title: Medical Accounts Receivable Specialist
Position Type: Permanent, Contract to Hire
Benefits: This position is eligible for Health, Vision, Dental and 401(K).
Pay: $26-28/HR
Key Responsibilities:
- Research and resolve insurance claim denials, rejections, payment discrepancies, and requests for additional information.
- Correct and resubmit claims, coordinate reconsiderations and appeals, and monitor claims through final payer determination.
- Work closely with Billing, Authorization, Credentialing, and Clinical teams to resolve reimbursement issues related to provider information, authorizations, enrollment, coding, and documentation.
- Track outstanding insurance balances, denial reasons, appeal status, and payer requirements while ensuring timely follow-up.
- Identify and research payment discrepancies, contractual adjustments, recoupments, unapplied cash, duplicate payments, and account variances.
- Assist with account reconciliations and communicate unresolved discrepancies to management.
- Identify trends in denials and potential revenue leakage related to expired authorizations, eligibility issues, provider enrollment, and claim submission errors.
- Prepare and coordinate supporting documentation for insurance appeals and reconsiderations within payer deadlines.
- Communicate recurring issues to appropriate departments and recommend process improvements to reduce denials and improve collections.
- Maintain accurate records and follow established billing, compliance, and HIPAA guidelines.
Qualifications:
- Previous experience in medical billing, insurance follow-up, accounts receivable, or revenue cycle management preferred.
- Experience researching insurance denials, submitting appeals, and resolving claim discrepancies.
- Knowledge of insurance reimbursement processes, payer requirements, and claim submission procedures.
- Strong attention to detail, organizational, and problem-solving skills.
- Ability to manage multiple accounts and meet timely filing and appeal deadlines.
- Strong communication skills and the ability to work cross-functionally with multiple departments.
- Experience in ABA therapy or behavioral health billing is a plus.