Remote AR Specialist - Medical Denials & Appeals Lead

Ensemble Health Partners; Oklahoma; Remote; USD 55,000 - 75,000; Full time

Benefits offered by this job

Tuition Reimbursement

Remote work

Bonus incentives

Job summary

Ensemble Health Partners is seeking a Sr Specialist, Accounts Receivable to handle follow up and denial activities with commercial, governmental, and other payers to secure timely reimbursement. The role mentors AR Specialist team members and analyzes denial trends to improve processes.

The position is remote with occasional travel to client sites or corporate offices as needed. A background in medical collections and strong Excel skills are required to support accurate billing and performance

Qualifications

• 1+ years of relevant experience in medical collections, AR follow-up, denials & appeals, compliance, provider relations or professional billing preferred.
• Knowledge of claims review and analysis.
• Experience working the DDE Medicare system and using payer websites to investigate claim statuses.

Responsibilities

• The Sr Specialist, Accounts Receivable performs all follow up and denial activities. Responsible for following up directly with commercial, governmental, and other payers to resolve claim payment issues, to secure appropriate and timely reimbursement and response.
• Mentors AR Specialist team members to help develop and improve their skills in the denials and appeals process.
• Examines denied and other non-paid claims to determine reason for discrepancies.
• Demonstrates initiative in resolving complex claims and proactively makes recommendations to management on specific trends or necessary interventions.
• Communicates directly with payers to follow up on outstanding claims, files technical and clinical appeals, resolve payment variances, and ensures timely and accurate reimbursement.

Skills

Accounts Receivable follow-up

Denials & appeals

Problem solving

Critical thinking

Communication skills

Education

High School Diploma or GED

Tools

Microsoft Excel

DDE Medicare system

Job description

Ensemble Health Partners is seeking a Sr Specialist, Accounts Receivable to handle follow up and denial activities with commercial, governmental, and other payers to secure timely reimbursement. The role mentors AR Specialist team members and analyzes denial trends to improve processes.

The position is remote with occasional travel to client sites or corporate offices as needed. A background in medical collections and strong Excel skills are required to support accurate billing and performance