Remote AR Resolution Specialist - Denials & Appeals

Jobgether; New Jersey; Remote; USD 60,000 - 80,000; Full time

Benefits offered by this job

Healthcare coverage

Life insurance

Flexible Spending Accounts (FSA)

PTO 160 hours + holidays

Remote work

EAP

Job summary

Partner Organization is seeking an Accounts Receivable Resolution Specialist in the United States for a fully remote, full-time role to ensure accurate insurance claims processing, reimbursement, and resolution.

You will manage complex AR cases, investigate denials, and coordinate appeals to accelerate payments from insurers and third-party payers, collaborating with billing teams, providers, patients, and payers.

Qualifications

• Hands-on experience in insurance claims follow-up, denial management, and healthcare billing.
• High school diploma, GED, or international equivalent.
• At least 2 years of experience in insurance claims follow-up.
• At least 2 years of experience in claims denial management.
• At least 5 years of experience working in a physician and/or healthcare facility business office.
• At least 1 year of experience working in a remote environment.
• Strong knowledge of insurance billing, claims follow-up, appeals, reimbursement processes, and denial resolution.
• Excellent analytical, organizational, and prioritization skills, with the ability to manage multiple complex accounts.
• Compliance with vaccination policies and related requirements prior to start date.
• At least 5 years of experience in physician and/or facility billing or auditing within a behavioral health environment.

Responsibilities

• Follow up on assigned accounts daily to reduce outstanding accounts receivable and accelerate reimbursement.
• Review denied claims promptly and accurately, identifying resolution strategies, including authorization, retroactive authorization, and precertification.
• Prepare and submit appeal letters and payer-required documentation through WAYSTAR for unpaid or underpaid claims.
• Prioritize account resolution activities to improve efficiency and maximize collection outcomes.
• Document all actions and progress using standardized note formats in Avatar and WAYSTAR.
• Meet established departmental productivity and performance requirements.
• Follow established reporting lines and participate in departmental initiatives designed to reduce outstanding accounts receivable.
• Assist billing teams in determining appropriate responses to incoming mail and other correspondence.

Skills

Claims follow-up

Denial management

Healthcare billing

Analytical skills

Education

Bachelor's in healthcare

Tools

Waystar

Avatar

Job description

Partner Organization is seeking an Accounts Receivable Resolution Specialist in the United States for a fully remote, full-time role to ensure accurate insurance claims processing, reimbursement, and resolution.

You will manage complex AR cases, investigate denials, and coordinate appeals to accelerate payments from insurers and third-party payers, collaborating with billing teams, providers, patients, and payers.