Remote AR & Denials Specialist - Claims Resolution

Align ENT + Allergy; King of Prussia (PA); Remote; USD 60,000 - 78,000; Full time

Job summary

Align ENT + Allergy is seeking an AR & Denials Specialist to actively manage and resolve outstanding insurance AR and denied claims across practices and payers. You will rely on strong eClinicalWorks (eCW) skills and payer portal access to review histories and determine next actions.

You will own queues, research denials, file corrected claims and appeals, and document outcomes with precision while working remotely in a high-volume environment.

Qualifications

• Minimum of 2 years of medical insurance AR and/or denial management experience.
• Strong hands-on experience with eClinicalWorks (eCW).
• Experience independently working insurance accounts receivable and denied claims.
• Strong experience using insurance payer portals.
• Demonstrated expertise working with at least one commercial or government insurance payer.
• Experience with appeals, reconsiderations, corrected claims, and payer follow-up.
• Experience identifying and responding to medical-record or additional documentation requests.
• Ability to read and interpret EOBs, ERAs, and denial reason codes.
• Working knowledge of the medical claim lifecycle.
• Strong research, critical-thinking, and problem-solving skills.
• Ability to independently review an account and determine the appropriate next action.
• Strong written documentation and communication skills.
• Ability to organize and prioritize a high-volume workload.
• Ability to work independently and effectively in a fully remote environment.

Responsibilities

• Independently work assigned AR and denial work queues within eClinicalWorks.
• Research unpaid, denied, rejected, and underpaid insurance claims.
• Review claim history, remittance information, EOBs, account notes, and previous follow-up activity to determine the appropriate next action.
• Utilize insurance payer portals to research claim status, denials, correspondence, and additional documentation requests.
• Identify and respond to payer requests for medical records and supporting documentation.
• Upload medical records and other requested documentation through payer portals.
• Prepare and submit corrected claims, reconsiderations, and appeals as appropriate.
• Interpret EOBs, ERAs, CARC/RARC codes, and payer denial information.
• Research payer policies and billing requirements as necessary to resolve outstanding claims.
• Identify issues related to eligibility, authorization, referrals, timely filing, coordination of benefits, coding, medical necessity, credentialing, and payer processing.
• Follow claims through resolution rather than completing repetitive status follow-up.
• Maintain clear, complete, and accurate documentation within eClinicalWorks.
• Escalate accounts appropriately after reasonable independent research and follow-up have been completed.
• Identify recurring payer or denial trends and communicate potential systemic issues to RCM leadership.
• Collaborate with coding, claim submission, practice operations, and other revenue cycle teams when additional intervention is required.
• Maintain established productivity and quality expectations.
• Perform other duties as assigned.

Skills

AR denial management

eCW proficiency

Payer portals usage

Independent work

Remote work capability

Tools

eClinicalWorks (eCW)

Payer portals

Job description

Align ENT + Allergy is seeking an AR & Denials Specialist to actively manage and resolve outstanding insurance AR and denied claims across practices and payers. You will rely on strong eClinicalWorks (eCW) skills and payer portal access to review histories and determine next actions.

You will own queues, research denials, file corrected claims and appeals, and document outcomes with precision while working remotely in a high-volume environment.