Remote Medical AR Specialist – Claims & Billing

Raintree Systems, Inc.; Clifton (TX); Remote; USD 55,000 - 70,000; Full time

Benefits offered by this job

Remote Work/Work From Home

Paid Time Off/11 Paid Holidays/Year‑In

Health, Dental, Vision, HSA/FSA

401K with Company Match

Disability & Life Insurance

Employee Assistance Program

Paid Parental Leave

Job summary

Raintree Systems, Inc. is seeking an Accounts Receivable Specialist - Medical Claims for remote U.S. work (designated states).

You will manage billing for multispecialty services, submit clean claims, and handle follow-ups, write-offs, and appeals per payer guidelines to ensure timely reimbursement. Ideal candidates have 7+ years in medical insurance claims, proficiency in MS Office and Google Apps, and strong problem-solving and communication skills to work with multiple payers and patients

Qualifications

• High School Diploma, GED, or equivalent work experience.
• Experience in Medical Insurance Claims billing preferred.
• Minimum 7 years plus of experience required.
• Proficient in Microsoft Office (Outlook, Excel, Word) and Google applications.
• Proactive curiosity and basic AI fluency to identify efficiency gains and streamline daily workflows in a fast-paced setting.
• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
• Ability to define problems, collect data, establish facts, and identify trends.
• Ability to exercise good judgment and elevate issues appropriately.

Responsibilities

• Prepare and re-submit clean claims to various insurance companies either electronically or by paper in accordance with specific payer guidelines and/or contract requirements.
• Analyze and correct first pass rejected claims for completeness and accuracy of information for second pass clean claim submission.
• Research and perform all primary and secondary billing claim status follow up activities for assigned insurance plans.
• Review, evaluate and process all claim appeals through resubmission to insurance carriers with complete and accurate supporting documentation required.
• Research and recommend any customer account adjustments and/or write-offs to the Manager based upon collectability of account with insurance carrier or patient.
• Recognize and report claims problems, errors, and discrepancies to management in order to proactively identify and effectively resolve billing trends in a timely manner.
• Generate and submit monthly patient balance due statements to customers as dictated by the explanation of benefits received from their insurance carrier.
• Reviewing patient accounts, identifying delinquent accounts, and collecting overdue payments.
• Answering patient questions about billing and payments.
• Investigating and/or directing patient inquiries or complaints to the appropriate staff member.

Skills

Attention to detail

Problem solving

Communication

Proactive curiosity

AI fluency

Mathematical ability

Judgment

Education

High School Diploma or GED

Tools

Microsoft Office

Google Applications

Job description

Raintree Systems, Inc. is seeking an Accounts Receivable Specialist - Medical Claims for remote U.S. work (designated states).

You will manage billing for multispecialty services, submit clean claims, and handle follow-ups, write-offs, and appeals per payer guidelines to ensure timely reimbursement. Ideal candidates have 7+ years in medical insurance claims, proficiency in MS Office and Google Apps, and strong problem-solving and communication skills to work with multiple payers and patients