Remote AR Follow-Up Specialist – Medical Claims

Integrated Pain Management Medical Group, Inc.; Nevada; À distance; USD 34 000 - 41 000; Plein temps

Avantages offerts par ce poste

Medical, Dental, Vision

401K Plan with Employer Matching

License & Tuition Reimbursement

Paid Time Off

Holiday Pay & Floating Holiday

Résumé du poste

Boomerang Healthcare is seeking an AR Follow-Up Specialist to manage timely follow-up on Medicare, Commercial, and Workers’ Compensation claims for California and other payers. This remote role supports multiple states and emphasizes proactive outreach, denial prevention, and collaboration with billing and authorization teams.

The ideal candidate has 3+ years in AR follow-up, strong Excel skills, and experience with diverse EHR/PM systems.

Qualifications

• Follow-up on California Medicare, Commercial, and WC claims to ensure prompt adjudication.
• Direct outreach to payers and contractors to obtain status and documentation.
• Resolve rejections, underpayments, and incorrect fee schedule applications.
• Monitor WC timelines and state-mandated payment rules.
• Collaborate with authorization teams to ensure valid documentation before billing.

Responsabilités

• Perform timely follow-up on California Medicare, Commercial, and Workers’ Compensation claims to ensure prompt adjudication
• Conduct direct outreach to commercial payers, Medicare contractors, WC adjusters, case managers, and employers to obtain claim status, authorization verification, and documentation requirements
• Resolve claim rejections, underpayments, incorrect fee schedule applications, and missing documentation across payer types
• Track and manage Workers’ Compensation payer-specific timelines, including 30-day status cycles and state-mandated payment rules
• Monitor claims for timely filing, medical necessity, eligibility discrepancies, COB, and modifier accuracy
• Coordinate with authorization teams to confirm authorization validity and ensure required documentation is submitted prior to billing
• Escalate delayed or complex cases to appropriate internal team members or external partners
• Identify opportunities for appeal when claims are underpaid or incorrectly denied for Medicare, Commercial, and WC payers
• Prepare and submit appeal letters, reconsideration requests, and supporting documentation
• Identify and report recurring denial trends and collaborate with billing, coding, and authorization teams to prevent recurrence
• Assumes other responsibilities as appropriate to the position and organizational needs

Connaissances

AR follow-up

California Medicare

Commercial Billing

Workers’ Compensation

EHR/PM systems

Excel pivot tables

Formation

High school diploma or GED

Outils

IMS

NextGen

Athena

eClinicalWorks

Description du poste

Boomerang Healthcare is seeking an AR Follow-Up Specialist to manage timely follow-up on Medicare, Commercial, and Workers’ Compensation claims for California and other payers. This remote role supports multiple states and emphasizes proactive outreach, denial prevention, and collaboration with billing and authorization teams.

The ideal candidate has 3+ years in AR follow-up, strong Excel skills, and experience with diverse EHR/PM systems.