Remote AR Recovery & Denial Specialist

Integrated Pain Management Medical Group, Inc.; Yuma (AZ); À distance; USD 34 000 - 41 000; Plein temps

Avantages offerts par ce poste

Medical, Dental, Vision benefits

401(k) Plan with employer matching

Paid Time Off

License & Tuition Reimbursements

Résumé du poste

Boomerang Healthcare is seeking an AR Follow-Up Specialist to ensure timely follow-up on California Medicare and Commercial claims, with responsibilities spanning WC and rehab services. You will perform payer outreach, verify authorizations, and resolve denials while coordinating with billing, coding, and authorization teams to improve DSO and cash flow.

The role is remote with states AZ, CA, NM, NV, OR, TX and WA as hiring locations. Strong Excel and mid-level EHR experience are required.

Qualifications

• 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).
• Basic understanding of NCCI edits and payer-specific billing guidelines.
• Strong verbal and written communication skills; excellent attention to detail.
• Advanced proficiency in Microsoft Excel (formulas, pivot tables) and solid skills in other Microsoft Office applications.

Responsabilités

• Perform timely follow-up on California Medicare, Commercial, and Workers’ Compensation claims to ensure prompt adjudication.
• 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, 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.

Connaissances

AR follow-up

California billing

Commercial billing

Attention to detail

Communication skills

Formation

High school diploma or GED

Outils

IMS

NextGen

Athena

eClinicalWorks

Description du poste

Boomerang Healthcare is seeking an AR Follow-Up Specialist to ensure timely follow-up on California Medicare and Commercial claims, with responsibilities spanning WC and rehab services. You will perform payer outreach, verify authorizations, and resolve denials while coordinating with billing, coding, and authorization teams to improve DSO and cash flow.

The role is remote with states AZ, CA, NM, NV, OR, TX and WA as hiring locations. Strong Excel and mid-level EHR experience are required.