Accounts Receivable Specialist II

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for an Accounts Receivable Specialist II based in United States. This fully remote role supports the timely and accurate collection of outstanding healthcare insurance receivables. You will manage government and commercial payer accounts, investigate unpaid and denied claims, and identify opportunities to recover revenue. The position combines detailed claims research with direct communication with insurance carriers and healthcare providers. You will play an important role in resolving billing discrepancies, underpayments, authorization issues, and reimbursement challenges. Success requires strong knowledge of healthcare revenue cycle processes, payer requirements, and accounts receivable practices. You will work independently while collaborating with cross-functional teams to meet productivity, quality, and compliance objectives. The role offers an opportunity to make a measurable impact on financial performance within a healthcare-focused environment. Accountabilities Accounts receivable follow-up: Manage outstanding government and commercial healthcare insurance receivables, researching unpaid, denied, and underpaid claims to secure timely reimbursement. Eligibility and authorization: Verify or obtain patient eligibility, service authorizations, and applicable control numbers through payer websites, client systems, and direct communication with insurance carriers or providers. Claims research and resolution: Investigate missing information, billing errors, payment discrepancies, low reimbursement, denials, and other issues, taking appropriate action to resolve or resubmit claims. Payment and EOB analysis: Review Explanation of Benefits (EOBs), claims data, and applicable billing documentation to identify payments, adjustments, underpayments, and opportunities for recovery. Payer communication: Contact insurance carriers by phone or written correspondence to obtain claim payments, clarify requirements, pursue reconsiderations, and resolve outstanding issues. Appeals and documentation: Prepare technical appeal letters, obtain required medical documentation, research provider billing manuals, and support claims requiring clinical audit review. Contract and reimbursement review: Research contracts and claims information to validate underpayments and determine whether reimbursement aligns with applicable contractual requirements. Data and documentation management: Update patient demographics and insurance information, maintain accurate account notes, and follow prioritization, timely filing, and documentation protocols. Compliance: Handle patient information in accordance with HIPAA and applicable regulatory requirements, follow established compliance policies, and promptly escalation potential compliance concerns. Performance: Meet established productivity and performance expectations, including a target of approximately 55 claims per day or 275 claims per week. Requirements Education: High school diploma or GED required. Healthcare AR experience: At least three years of experience in healthcare insurance accounts receivable, preferably within a hospital or hospital system and involving direct interaction with government or commercial payers. Claims expertise: Demonstrated experience identifying billing errors, resubmitting claims, following up on payment discrepancies and denials, and addressing low reimbursement. Healthcare documentation: Experience reviewing EOBs and CMS-1500 forms as part of accounts receivable activities. Revenue cycle knowledge: Strong understanding of medical business office procedures, accounts receivable practices, coordination of benefits, denial overturns, and third-party payer billing and reimbursement processes. Systems experience: At least three years of experience using accounts receivable software, with experience navigating payer portals for benefits verification, appeals, reconsiderations, and online claims follow-up. Payer knowledge: Experience working with Medicare and Medicaid is required; familiarity with other government and commercial insurance processes is highly valuable. Technical skills: Proficiency with Microsoft Office, including Excel for data entry, sorting, and organization, as well as email, calendar, and web-based systems. Communication: Ability to communicate effectively with payers, interpret complex information, document interactions accurately, and maintain professional relationships. Collaboration and performance: Ability to work effectively with cross-functional teams, meet established performance objectives, and manage a high-volume workload with accuracy. Preferred experience: Experience with Epic is preferred, as is experience managing both hospital/facility and physician/professional-fee accounts receivable. Benefits Compensation: $20.00–$23.00 per hour, with actual compensation varying based on factors such as geographic location, experience, certifications, and skills. Work arrangement: Fully remote position within the United States. Healthcare environment: Opportunity to contribute directly to healthcare revenue cycle operations and financial performance. Professional development: Exposure to diverse payer processes, claims resolution, reimbursement practices, and healthcare compliance requirements. Collaborative culture: Work with cross-functional teams and healthcare stakeholders toward shared operational and financial goals. Equal opportunity: The role is offered in an environment committed to fair employment practices and equal opportunity. #J-18808-Ljbffr