The Accounts Receivable Specialist supports healthcare revenue cycle operations by submitting claims, following up on denied claims, and working with commercial insurance carriers to ensure accurate and timely payment.
- Monitor denied claims and reprocess them with correct demographic and coding information.
- Follow up on unpaid claims and work weekly AR reports to identify resolution opportunities.
- Initiate tracers with commercial carriers to locate missing or lost payments.
- Document all claim-related communication in the billing system.
- Identify recurring billing and denial trends and escalate them to leadership.
- Support billing and auxiliary teams as needed.
- Maintain confidentiality of patient information in compliance with HIPAA.
- Meet productivity expectations in a fast-paced, high-volume environment.
Requirements & Qualifications
- High school diploma or equivalent required.
- 2 years of medical billing experience preferred.
- Knowledge of medical billing and collections practices.
- Understanding of payer requirements, denials, and reimbursement processes.
- Basic knowledge of medical coding and third-party billing procedures.
- Experience with EMR, EDI, commercial insurance systems, and PM systems.
- Familiarity with out-of-network negotiations, appeals, and reconsiderations.
- Ability to interpret EOBs and CARC/RARC codes.
- Strong computer skills, including Microsoft Outlook, Teams, Excel, and Word.
- Strong organization, prioritization, communication, and writing skills.
- Must be able to work onsite in Houston, TX and flex hours as needed.
Location
Houston, Texas, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago
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