Revenue Cycle AR and Denials Specialist
Remote
Part Time to Full Time
Mid Level
Job Summary:
We are seeking a detail-oriented and experienced Revenue Cycle A/R and Denials Specialist to join our team. This role is responsible for managing accounts receivable (A/R), resolving claim denials, and ensuring timely reimbursement from insurance payers. The ideal candidate will have a strong background in medical billing, claim follow-up, and denial resolution.
Key Responsibilities:
This position may be based in an office, healthcare facility, or remote setting, depending on organizational needs. Standard work hours apply, with occasional overtime as necessary to meet deadlines.
We are seeking a detail-oriented and experienced Revenue Cycle A/R and Denials Specialist to join our team. This role is responsible for managing accounts receivable (A/R), resolving claim denials, and ensuring timely reimbursement from insurance payers. The ideal candidate will have a strong background in medical billing, claim follow-up, and denial resolution.
Key Responsibilities:
- Monitor and manage accounts receivable to ensure timely collections.
- Analyze and resolve denied and underpaid claims efficiently.
- Review explanation of benefits (EOBs) and remittance advices to determine reasons for denials.
- Appeal denied claims with insurance payers and follow up until resolution.
- Work closely with insurance companies, providers, and billing teams to minimize denials and optimize reimbursement.
- Maintain accurate documentation of claim status, appeals, and payment discrepancies.
- Identify trends in denials and recommend process improvements.
- Ensure compliance with federal, state, and payer-specific billing and reimbursement guidelines.
- Generate and review A/R and denial management reports.
- High school diploma or equivalent required; associate’s or bachelor’s degree in healthcare administration, finance, or related field preferred.
- Minimum of 2 years of experience in medical billing, accounts receivable, or denial management.
- Strong knowledge of insurance claim processes, medical coding (ICD-10, CPT, HCPCS), and payer guidelines.
- Proficiency in electronic health records (EHR) and billing software.
- Excellent problem-solving and analytical skills.
- Strong communication and negotiation skills.
- Ability to work independently and manage multiple tasks efficiently.
- Experience with Medicare and Medicaid claim resolution.
- Familiarity with managed care and commercial insurance plans.
- Certification in medical billing and coding (e.g., CPC, CCS, or CMRS) preferred.
This position may be based in an office, healthcare facility, or remote setting, depending on organizational needs. Standard work hours apply, with occasional overtime as necessary to meet deadlines.
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