Remote Medical Claims AR Specialist

Raintree Systems, Inc.; Orangeburg (SC); A distancia; USD 65.000 - 75.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

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

Descripción de la vacante

Raintree Systems, Inc. is hiring an Accounts Receivable Specialist - Medical Claims to ensure accurate, compliant, and timely billing for multispecialty medical services across various payers. This fully remote role covers designated U.S.

states and requires 7+ years experience in medical claims billing, with proficiency in Microsoft Office and Google applications. The successful candidate will manage clean claim submissions, follow-ups, rebilling, and appeals, while addressing delinquent

Formación

• 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.

Responsabilidades

• 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.

Descripción del empleo

Raintree Systems, Inc. is hiring an Accounts Receivable Specialist - Medical Claims to ensure accurate, compliant, and timely billing for multispecialty medical services across various payers. This fully remote role covers designated U.S.

states and requires 7+ years experience in medical claims billing, with proficiency in Microsoft Office and Google applications. The successful candidate will manage clean claim submissions, follow-ups, rebilling, and appeals, while addressing delinquent