Medical Accounts Receivable (A/R) Specialist

Job Description

Job Description

Arthritis Associates of Florida is seeking an experienced, detail-oriented, and highly motivated Medical Accounts Receivable (A/R) Specialist to join our growing rheumatology practice. This position is ideal for a revenue cycle professional who excels at resolving complex insurance claims, reducing aged accounts receivable, and navigating payer reimbursement issues for specialty medications and infusion services.

The ideal candidate will have a strong background in medical billing and collections, be proficient in eClinicalWorks (eCW) , and possess the analytical skills necessary to successfully manage legacy account cleanup and ongoing revenue cycle activities.

What You'll Do

• Work aged accounts receivable and aggressively pursue outstanding insurance and patient balances.
• Investigate, appeal, and resolve denied, underpaid, and unpaid claims.
• Perform detailed insurance follow-up with Medicare, and commercial payers.
• Review and reconcile legacy billing accounts and historical balances.
• Research and resolve payment posting discrepancies, unapplied cash, and credit balances.
• Submit claim corrections, reconsiderations, and appeals.
• Verify reimbursement according to payer contracts and fee schedules.
• Conduct insurance benefits investigations for infusion therapies and biologic buy-and-bill medications.
• Verify coverage, prior authorization requirements, deductibles, coinsurance, and patient financial responsibility.
• Follow up on high-dollar infusion claims and specialty drug reimbursement issues.
• Maintain accurate account documentation within eClinicalWorks.
• Collaborate with clinical, front office, and billing teams to ensure accurate claim submission and reimbursement.

Qualifications

Required

• Minimum of 3 years of medical accounts receivable, billing, or insurance follow-up experience.
• Demonstrated experience resolving complex insurance claims and denials.
• Strong working knowledge of Medicare, Medicare Advantage, commercial insurance, and manufacture copay assistance programs.
• Proficiency in eClinicalWorks (eCW) Practice Management and EHR systems.
• Proficient knowledge of CPT, ICD-10, HCPCS, modifiers, and medical terminology.
• Excellent organizational skills and attention to detail.
• Strong written and verbal communication skills.
• Ability to work independently while meeting productivity and quality goals.

Preferred

• Rheumatology, infusion, oncology, gastroenterology, or specialty practice experience.
• Experience with biologic medications and buy-and-bill reimbursement.
• Knowledge of infusion coding, prior authorizations, and copay assistance programs.
• Experience with legacy system cleanup and data reconciliation projects.

Skills & Competencies

✔ Expertise in insurance follow-up and denial management
✔ Strong analytical and problem-solving abilities
✔ Thorough understanding of revenue cycle management
✔ Experience with high-dollar specialty and infusion claims
✔ Proficiency in payer portals and electronic claim systems
✔ Ability to prioritize and manage large volumes of aged accounts
✔ Commitment to accuracy, compliance, and confidentiality
✔ Strong customer service and professional communication skills

We are a well-established, physician-led rheumatology practice with two providers, offering a highly collaborative environment where team members take ownership, work closely with the physician, and play a meaningful role in managing complex autoimmune conditions and delivering consistent, relationship-driven patient care.

Company Description

We are a well-established, physician-led rheumatology practice with two providers, offering a highly collaborative environment where team members take ownership, work closely with the physician, and play a meaningful role in managing complex autoimmune conditions and delivering consistent, relationship-driven patient care.