Remote AR Specialist – Medicare & WC Claims

Integrated Pain Management Medical Group, Inc.; New Mexico; Remote; USD 34,000 - 41,000; Full time

Benefits offered by this job

Medical benefits

401(k) with employer matching

Paid time off

License & Tuition reimbursement

Holiday pay

Discount programs

Job summary

Boomerang Healthcare seeks an AR Follow-Up Specialist to ensure timely and accurate follow-up on CA Medicare, Commercial, and WC claims. You will outreach to payers, verify authorizations, and resolve denials while coordinating with billing and coding teams.

The role supports remote work in AZ, CA, NM, NV, OR, TX and WA, with expectations to reduce DSO and optimize cash flow through denial prevention strategies.

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.
• Experience with multiple EHR / Practice Management systems (IMS, NextGen, Athena, eClinicalWorks, or similar).
• 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.

Responsibilities

• 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, 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.

Skills

AR follow-up

Attention to detail

Communication

Time management

Education

High school diploma or GED

Tools

IMS

NextGen

Athena

eClinicalWorks

Job description

Boomerang Healthcare seeks an AR Follow-Up Specialist to ensure timely and accurate follow-up on CA Medicare, Commercial, and WC claims. You will outreach to payers, verify authorizations, and resolve denials while coordinating with billing and coding teams.

The role supports remote work in AZ, CA, NM, NV, OR, TX and WA, with expectations to reduce DSO and optimize cash flow through denial prevention strategies.