Role Description
The A/R Management Specialist II position will provide support for all revenue cycle activities related to outstanding insurance accounts receivable, insurance denials, and appeals. This includes insurance and patient billing follow-up to ensure prompt and accurate payment to the client or provider for all monies owed. The responsibilities of the A/R Management Specialist II will include a higher level of analysis and resolving more complex claim rejections and denials.
-
Perform job responsibilities and tasks according to company standards, as well as state and federal guidelines
-
Make telephone calls to patients, hospitals, insurance companies, facilities, and attorneys as needed to research claims or obtain additional insurance information
-
Contact insurance carriers to inquire about the status of past-due accounts
-
Meet or exceed defined productivity and quality standards
-
Document details of activity on each account in the claims processing system
-
Follow up on accounts, including contacting patients by telephone to inquire about insurance coverage
-
Maintain workflow to keep aging accounts at a minimum by following up on unpaid claims regularly
-
Follow up on accounts that have reached collections to ensure they have been fully worked before referral to an external collection agency
-
Follow up on any assigned special projects designated by the Manager
-
Demonstrate the highest level of compliance with all laws and regulations, including but not limited to HIPAA
-
Problem-solve and provide complete resolution for complex accounts and escalations
-
Perform quality checks on assigned claims
-
Ensure consistent adherence to company attendance policies
-
Additional job duties as assigned
Qualifications
-
High School Diploma or equivalent required; Associates Degree preferred
-
Minimum of 2 yearsβ experience in healthcare claims processing, billing, or accounts receivable
-
Hands-on experience preparing and submitting insurance appeals, including understanding payer denial codes and payer timely filing limits
-
Familiarity with ICD-10, HCPCS, and general medical terminology
-
EMS billing experience strongly preferred; experience in other medical specialties will be considered
-
Proficiency with various web platforms, including billing software and payer portals
-
Prior customer service experience with the ability to work collaboratively with other departments and team members
-
Basic computer knowledge and experience using Microsoft Office
-
Strong interpersonal, organizational, communication, and time-management skills
-
Strong investigative and research skills, with the ability to resolve complex billing issues
-
Effective critical thinking and analytical abilities
-
Ability to work independently in a fast-paced, adaptive environment with minimal supervision
-
Strong customer service skills and experience
-
Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment
Benefits
-
Competitive salary, commensurate with experience
-
Comprehensive benefits package, including 401(k) Plan