Remote AR Follow-Up Specialist – Medicare & Commercial

Integrated Pain Management Medical Group, Inc.; Phoenix (AZ); Remote; USD 34.000 - 41.000; Vollzeit

Benefits dieser Stelle

Medical, Dental, Vision benefits

401K Plan with Employer Matching

Paid Time Off

Holiday Pay

Zusammenfassung

Boomerang Healthcare is seeking an AR Follow-Up Specialist to manage follow-up on California Medicare, Commercial, and Workers’ Compensation claims from a remote location across AZ, CA, NM, NV, OR, TX, and WA. You will perform payer outreach, verify authorizations, monitor denials, and coordinate with billing and coding teams to optimize reimbursements.

The role emphasizes reducing DSO, improving cash flow, and preventing denials through proactive communication with payers, while collaborating

Qualifikationen

• High school diploma or GED required.
• 3+ years of AR follow-up experience with strong emphasis on California Medicare and Commercial billing.
• Working knowledge of Workers’ Compensation billing, including adjuster communication, state rules, medical necessity, and required documentation.
• Experience managing mixed payer AR inventories with competing timelines and requirements.
• Ability to work in a fast-paced environment, meet daily deadlines, and collaborate with cross-functional RCM teams.
• Experience with multiple EHR / Practice Management systems (IMS, NextGen, Athena, eClinicalWorks, or similar).
• Advanced proficiency in Microsoft Excel (formulas, pivot tables) and solid skills in other Microsoft Office applications.

Aufgaben

• 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 (clinical notes, C-4/C-9 forms, MMI/RTW documentation, etc.).
• 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, coordination of benefits (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

Kenntnisse

AR follow-up

California Medicare billing

Commercial billing

Workers’ Compensation billing

EHR/PM systems

Microsoft Excel

Ausbildung

High school diploma or GED

Tools

IMS

NextGen

Athena

eClinicalWorks

Jobbeschreibung

Boomerang Healthcare is seeking an AR Follow-Up Specialist to manage follow-up on California Medicare, Commercial, and Workers’ Compensation claims from a remote location across AZ, CA, NM, NV, OR, TX, and WA. You will perform payer outreach, verify authorizations, monitor denials, and coordinate with billing and coding teams to optimize reimbursements.

The role emphasizes reducing DSO, improving cash flow, and preventing denials through proactive communication with payers, while collaborating