Remote Medical Claims AR Specialist

Raintree Systems, Inc.; Carson City (NV); Remote; USD 52,000 - 65,000; Full time

Benefits offered by this job

Remote work from home

Health benefits

Job summary

Raintree Systems, Inc. is seeking an Accounts Receivable Specialist - Medical Claims for a fully remote role. You will manage billing and reimbursement for multispecialty services, resubmit claims per payer guidelines, and handle follow-up on claim statuses and appeals.

The role requires attention to detail, analytical thinking, and strong teamwork. Experience in medical insurance claims billing and proficiency with Microsoft Office and Google Workspace are preferred; flexibility and independent

Qualifications

• High School Diploma, GED, or equivalent work experience.
• Experience in Medical Insurance Claims billing preferred.
• Proficient in Microsoft Office (Outlook, Excel, Word) and Google applications.
• 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.
• Must work well within a team structure, possessing outstanding interpersonal relationship skills, as well as the ability to work independently.
• HR policies, standard operating procedures, and other corporate initiatives.

Responsibilities

• Ensures accurate, compliant, timely billing and appropriate reimbursement for multispecialty medical professional services from various insurance payers and patients.
• 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

Analytical thinking

Teamwork

Communication skills

Education

High School Diploma

Tools

Microsoft Office

Google Workspace

Job description

Raintree Systems, Inc. is seeking an Accounts Receivable Specialist - Medical Claims for a fully remote role. You will manage billing and reimbursement for multispecialty services, resubmit claims per payer guidelines, and handle follow-up on claim statuses and appeals.

The role requires attention to detail, analytical thinking, and strong teamwork. Experience in medical insurance claims billing and proficiency with Microsoft Office and Google Workspace are preferred; flexibility and independent