Collections Specialist - Medical Claims

The AR Follow-Up Specialist is responsible for timely and accurate follow-up of outstanding accounts receivable within the Revenue Cycle Management (RCM) department. This role primarily supports California Medicare and Commercial AR, with additional responsibility for Workers’ Compensation and Rehab services. The position ensures optimal reimbursement through proactive payer outreach, claim status monitoring, denial resolution, and coordination with billing, coding, and authorization teams. The AR Specialist plays a key role in reducing days sales outstanding (DSO), improving cash flow, and supporting denial prevention strategies across all payer types. *This is a remote role. We are only hiring in the following states: AZ, CA, NM, NV, OR, TX and WA. What you will do: Perform timely follow-up on California Medicare, Commercial, and Workers’ Compensation claims to ensure prompt adjudication Conduct direct outreach to commercial payers, Medicare contractors, WC adjusters, case managers, and employers to obtain claim status, authorization verification, and documentation requirements Resolve claim rejections, underpayments, incorrect fee schedule applications, and missing documentation across payer types (clinical notes, C-4/C-9 forms, MMI/RTW documentation, etc.) Track and manage Workers’ Compensation payer-specific timelines, including 30-day status cycles and state-mandated payment rules Monitor claims for timely filing, medical necessity, eligibility discrepancies, coordination of benefits (COB), and modifier accuracy Coordinate with authorization teams to confirm authorization validity and ensure required documentation is submitted prior to billing Escalate delayed or complex cases to appropriate internal team members or external partners Identify opportunities for appeal when claims are underpaid or incorrectly denied for Medicare, Commercial, and WC payers Prepare and submit appeal letters, reconsideration requests, and supporting documentation Identify and report recurring denial trends and collaborate with billing, coding, and authorization teams to prevent recurrence Assumes other responsibilities as appropriate to the position and organizational needs Qualifications: High school diploma or GED required 3+ years of AR follow-up experience with strong emphasis on California Medicare and Commercial billing Working knowledge of Workers’ Compensation billing, including adjuster communication, state rules, medical necessity, and required documentation Experience managing mixed payer AR inventories with competing timelines and requirements Ability to work in a fast-paced environment, meet daily deadlines, and collaborate with cross-functional RCM teams Experience with multiple EHR / Practice Management systems (IMS, NextGen, Athena, eClinicalWorks, or similar) Basic understanding of NCCI edits and payer-specific billing guidelines Strong verbal and written communication skills; excellent attention to detail Advanced proficiency in Microsoft Excel (formulas, pivot tables) and solid skills in other Microsoft Office applications Compensation Range: $25.00 to $30.00 Hourly All compensation ranges are posted based on internal equity, job requirements, experience, and geographical locations. Why You'll Love Working Here: Amazing work/life balance Generous Medical, Dental, Vision, and Prescription benefits (PPO & HMO) 401(K) Plan with Employer Matching License & Tuition Reimbursements Paid Time Off Holiday Pay & Floating Holiday Employee Perks and Discount Programs Supportive environment to help you grow and succeed Boomerang Healthcare (BHC) is a multidisciplinary and comprehensive team of experienced, committed healthcare providers that treat pain. Our team of doctors approaches each patient with one goal in mind: to help patients return to normal daily activities. We work with our patients to identify the cause of their pain and create a personalized treatment plan, recognizing that no two patients are alike, and neither is their pain. Our providers create a comprehensive care plan, then monitor, manage and coordinate patient access to health services at BHC. Boomerang Healthcare strives to be a diverse workforce that reflects, at all job levels, the patients we serve. We are an equal opportunity employer. Boomerang Healthcare is committed to compliance with the American Disabilities Act. If you require reasonable accommodation during the application process or have a question regarding an essential job function, please contact us. Monday-Friday, 8am-5pm 40 #J-18808-Ljbffr Integrated Pain Management Medical Group, Inc.