AR / Patient Service Rep

Accounts Receivable Specialist – Multi‑site Dermatology Group Optima Dermatology is recruiting a full‑time RCM Accounts Receivable Specialist to join our Practice Support Center. Remote opportunities are available for residents of ME, NH, MA, IN, OH, FL, and NC. Position Summary The specialist will resolve aging claims, work denials, oversee secondary claims, and collaborate closely with other revenue cycle teams to ensure timely and accurate resolution of accounts. The role also involves patient account management and requires strong communication and critical thinking skills. Responsibilities Review and resolve rejected claims and post EOBs, payments, and adjustments. Research and validate posted payments and adjustments, correcting discrepancies as needed. Process correspondence to resolve open A/R balances for assigned providers, payers, and claims. Analyze denials and underpayments to determine appeals or other resolutions. Identify and communicate denial and payment trends to improve billing procedures. Collaborate with payers, EDI, and payment posting teams to address systemic issues and streamline processes. Resubmit claims to secondary/tertiary payers as needed. Maintain accurate logs of payer interactions and unresolved balances. Utilize provider portals and payer resources to research and resolve claim processing issues. Manage incoming calls from insurance companies regarding claims and requests for additional documentation. Understand and interpret insurance EOBs. Provide excellent customer service, assisting patients with billing inquiries, account balances, and financial responsibilities. Manage incoming patient calls efficiently, resolving concerns and escalating issues as needed. Assist clinical and operational staff with patient demographics, scheduling, and referrals. Educate patients on cost and payment options for services. Analyze and resolve patient account billing issues through communication with patients, insurance providers, and healthcare systems. Demonstrate effective call handling, including deescalating patients, by managing incoming patient calls via the phone queue and resolving billing questions and concerns. Verify insurance eligibility and benefits as needed using automated eligibility systems, payer websites, and calls to insurance carriers. Keep management informed about backlogs, time availability, and unresolved concerns. Maintain set standards, metrics, all KPIs and ensure individual and departmental goals are met. Accurately document patient accounts and all actions taken. Respond promptly to emails, voicemails, and assigned tasks. Maintain a thorough understanding of the practice management system and electronic medical records (EMR). Function as a resource to answer questions promptly and accurately including questions from other team members, management, and payors. Work as a collaborative team member within a distributed organization. Participate in revenue cycle projects and contribute to departmental goals for the same. Work assigned intradepartmental and interdepartmental inquiries within a timely manner. Follow all HIPAA guidelines and comply with annual training and understand and operate within defined scope as outlined by the company. Demonstrate our values in interactions, empathy, and sensitivity towards patient/family rights. Other duties assigned by the Supervisor, Manager, or Director. Qualifications Minimum of 3 years in healthcare reimbursement preferred. CPT and ICD‑10 coding. Payer billing guidelines, submission, and remittance processes. HCFA 1500 forms and Explanation of Benefits (EOBs). Strong problem‑solving, prioritization, and follow‑through abilities. Excellent interpersonal and communication skills, with a proven record of professional etiquette. Ability to work independently in a demanding environment. High school diploma or equivalent. Degree/certification or structured secondary education strongly preferred. Strong initiative, judgment, and decision‑making skills. Ability to build rapport with patients and colleagues while maintaining empathy and sensitivity. Collaborative within a distributed organization. Adherence to company values, professionalism, and HIPAA compliance. Compensation and Benefits The position will offer competitive compensation and personal reward associated with transforming our patients’ lives and building the most defensible healthcare services platform in the country. Benefits include generous health, dental, vision, disability, and life insurance. About Optima Dermatology Our mission to revolutionize skin care is made possible by a world‑class team that is highly engaged, mission‑driven, and inspired to set the new standard in dermatology. We are growing rapidly and looking for key team members who believe in our mission and want to make a difference in the lives of our patients. #J-18808-Ljbffr Optima Dermatology