Revenue Success Advocate (Accounts Receivable Specialist) ONSITE

Job Summary / Objective The Revenue Success Advocate is responsible for ensuring timely and accurate reimbursement of claims by managing accounts receivable workflows, including claim follow-up, denial resolution, payment review, and account reconciliation. This role plays a critical part in maintaining the organization’s financial performance through proactive account management, collaboration with payors and internal stakeholders, and delivery of high-quality customer service to patients and clinic partners. Key Responsibilities Claim Follow-Up & Collections: Proactively contact insurance payers to obtain claim status updates, resolve discrepancies, and secure reimbursement on outstanding balances. Process claim corrections, resubmissions and account adjustments as needed. Denial Resolution: Investigate denied or underpaid claims by reviewing medical records, coding, and payer guidelines; take corrective action to ensure proper reimbursement. Appeals Management: Prepare, write, and submit detailed appeals for complex or escalated denials while ensuring compliance with payer requirements and regulations. Payment Verification: Review and validate insurance payments against contractual rates; identify and resolve underpayments or inaccuracies. Patient Account Management: Maintain accurate patient financial records, document all activity and follow-up actions, and ensure timely resolution of outstanding balances. Correspondence Review & Response: Review insurance and patient correspondence to determine appropriate action; respond to patient billing concerns and questions with clear, timely, and professional communication. Data & Trend Analysis: Review clearinghouse rejections, denial trends, and payment patterns; identify root causes and recommend process improvements. Cross-Functional Coordination: Collaborate with providers, clinical staff, and internal teams to obtain necessary documentation, referrals, and authorizations for claim resolution. Productivity and Quality: Meet established productivity, quality, and accuracy standards. Additional Duties & Skills Perform payment posting, including accurate application of insurance and patient payments. Provide patient and clinic customer service by addressing billing inquiries and resolving concerns promptly and professionally. Conduct daily charge review to verify accuracy and completeness prior to claim submission. Serve as backup support for charge entry and payment posting functions to ensure operational continuity. Identify and support process improvement opportunities within revenue cycle workflows. Participate in team initiatives and special projects as assigned. Required Skills & Abilities Expertise in navigating and querying insurance payer portals and websites. Strong ability to read and interpret Explanation of Benefits (EOBs). Proficiency in healthcare terminology and medical coding fundamentals (CPT, HCPCS, ICD). Excellent time management and organizational skills with ability to manage high-volume workloads. Strong written and verbal communication skills. Ability to effectively communicate with patients, payors, and internal stakeholders. Competency in Microsoft Office 365, especially Excel. Strong attention to detail and problem‑solving ability. Education & Experience High school diploma or equivalent. Minimum of 2 years of experience in insurance payment posting and/or accounts receivable follow-up across multiple payors. Experience working in an Electronic Medical Record (EMR) system. Preferred Experience with denial management and appeals processes. Familiarity with payer contracts and reimbursement methodologies. Certification in medical billing or coding (e.g., CPC, CPB). #J-18808-Ljbffr Urgent-Care-For-Kids