Remote Medical AR Specialist – Claims & Rebilling Expert

Raintree Systems, Inc.; South Carolina; Remote; USD 52,000 - 70,000; Full time

Benefits offered by this job

Remote Work/Work From Home

Paid Time Off/11 Paid Holidays/Year

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 a fully remote role within designated U.S. states.

The candidate will manage accurate and timely billing, collections, and reimbursements for multispecialty medical services across payers and patients. Responsibilities include submitting claims, following up on status, handling appeals, and resolving billing issues while complying with HIPAA and internal policies.

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

Medical billing

Accounts receivable

HIPAA compliance

Communication

Attention to detail

Team collaboration

Education

High School Diploma or GED

Tools

Microsoft Office

Excel

Google Apps

Job description

Raintree Systems, Inc. is seeking an Accounts Receivable Specialist - Medical Claims for a fully remote role within designated U.S. states.

The candidate will manage accurate and timely billing, collections, and reimbursements for multispecialty medical services across payers and patients. Responsibilities include submitting claims, following up on status, handling appeals, and resolving billing issues while complying with HIPAA and internal policies.