Senior Medical Accounts Receivable Specialist

Job Description

Job Description

The Cardiovascular Care Group

Position Summary

The Cardiovascular Care Group is seeking an experienced and detail-oriented Senior Accounts Receivable Specialist to join our Revenue Cycle team. The Senior AR Specialist is responsible for managing complex accounts receivable activities, resolving outstanding insurance and patient balances, and ensuring timely reimbursement for cardiovascular services. This role serves as a subject matter expert in claims follow-up, denial management, payer regulations, and revenue cycle best practices while supporting overall financial performance and patient satisfaction.

The ideal candidate possesses extensive medical accounts receivable experience, strong analytical skills, and a comprehensive understanding of physician practice billing, payer requirements, and healthcare reimbursement methodologies.

Essential Responsibilities

Medical Accounts Receivable Management

• Monitor and manage assigned AR portfolios to ensure timely collection of outstanding balances.
• Analyze aging reports and identify trends impacting cash collections and AR performance.
• Follow up on unpaid, underpaid, denied, or delayed claims with commercial payers, Medicare, Medicaid, and managed care organizations.
• Research and resolve complex reimbursement issues and account discrepancies.
• Ensure prompt resolution of credit balances and payer recoupments.

Denial Management & Appeals

• Investigate and resolve claim denials, rejections, and payment variances.
• Prepare and submit comprehensive appeal packages with supporting medical documentation.
• Track appeal outcomes and implement corrective actions to reduce future denials.
• Identify root causes and recommend process improvements to optimize reimbursement.

Revenue Cycle Support

• Work closely with coding, charge entry, credentialing, clinical, and front-end teams to address billing issues.
• Review payer policies and reimbursement guidelines to ensure compliance and maximize collections.
• Assist in identifying workflow improvements that enhance revenue cycle efficiency and effectiveness.
• Support month-end reporting and collection performance analysis.
• Assist with onboarding and training of new billing and collections staff.
• Share best practices and contribute to departmental performance improvement initiatives.
• Participate in special projects and process improvement efforts as assigned.

Compliance & Quality Assurance

• Maintain compliance with HIPAA, payer regulations, and applicable healthcare laws.
• Ensure accurate documentation of account activities within the practice management system.
• Adhere to established organizational policies and procedures.
• Support internal and external audits as needed.

Qualifications

Education

• High School Diploma or GED required.
• Associate's degree in Healthcare Administration, Business, Finance, or related field preferred.

Experience

• Minimum of 5 years of medical accounts receivable experience required.
• Minimum of 2 years in a senior, lead, or advanced AR role preferred.
• Experience with physician surgical practice billing required.
• Cardiovascular or surgical specialty physician practice experience preferred.
• Experience working with Medicare, Medicaid, commercial insurance carriers, and managed care plans.

Knowledge, Skills & Abilities

• Strong understanding of healthcare revenue cycle operations.
• Expertise in denial management, appeals, collections, and payer follow-up.
• Knowledge of CPT, ICD-10, HCPCS coding concepts and reimbursement methodologies.
• Proficiency with electronic medical records (EMR) and practice management systems.
• Excellent analytical, organizational, and problem-solving abilities.
• Strong verbal and written communication skills.
• Ability to prioritize multiple tasks and meet deadlines in a fast-paced environment.
• Demonstrated commitment to accuracy, confidentiality, and customer service.

Preferred Qualifications

• 2 years+ Surgical Practice AR Collections
• Experience with cardiovascular procedures, diagnostics, and related billing requirements.

Benefits:

• Medical (100% paid by the group for Employee Only coverage with the Cigna Bronze plan).
• Dental – three plans to choose from Delta Dental and Cigna.
• Vision – two plans to choose from Delta VSP.
• Health Savings Account and Flexible Spending Accounts (Healthcare, Dependent Care, Transit and Parking) through Upswing.
• Life Insurance – $25,000 Paid by the group with the option to enroll in additional Voluntary Life Insurance coverage.
• Short-Term Disability and Long-Term Disability through New York Life with the option to enroll in additional voluntary coverage.
• Ancillary optional benefits – Accident, Critical Illness and Hospital Indemnity through New York Life.
• Paid Time Off
• Holiday Pay
• Paid Jury Duty – 1 day of full pay.
• Employee Assistance Programs through RWJBH and Cigna.
• 401k Employer Contributions – upon eligibility, group contributes 3%
• Working Advantage and Life Mart Employee Discounts.
• Holiday Party, Employee Appreciation Days, Ice Cream Socials, various Fundraisers and Contests (receive prizes!) – Lots of employee engagement.