Revenue Cycle AR Specialist

IN SUMMARY...

The Revenue Cycle Accounts Receivable (A/R) Specialist is responsible for managing and resolving outstanding accounts to ensure timely reimbursement and optimal cash flow. This role focuses on analyzing aged receivables, following up with payers, and addressing claim issues that delay payment.

The A/R Specialist plays a critical role in reducing aging balances by investigating denials, underpayments, and unpaid claims, while identifying root causes and implementing corrective actions. This position requires strong analytical skills, attention to detail, and a proactive approach to resolving barriers to payment.

Working closely with internal teams and payers, the A/R Specialist helps improve revenue cycle performance by ensuring accurate follow-up, minimizing revenue leakage, and contributing to continuous process improvement.

WHAT YOU WILL DO...

• Monitor A/R aging reports and prioritize high-value or high-risk accounts. ● Manage and prioritize assigned A/R work queues, focusing on accounts aged 30/60/90+ days, to prevent claims from aging beyond 91+ days.
• Perform timely follow-up with insurance payers via phone, portals, or correspondence to resolve unpaid or underpaid claims.
• Ensure all follow-up activities are documented accurately and in a timely manner. ● Investigate denied or underpaid claims to determine root cause. ● Correct claim errors and resubmit claims or file appeals as appropriate. ● Identify patterns in denials and escalate trends for process improvement. ● Research and resolve payment discrepancies, including partial payments and contractual variances.
• Identify and escalate potential payer issues, system errors, or configuration gaps. ● Maintain productivity benchmarks and establish KPI's while ensuring quality and accuracy of work.
• Ensure all work complies with payer regulations, billing guidelines, and internal SOPs.
• Communicate effectively with payer representatives to obtain claim status, resolve issues, and expedite payment.
• Navigate payer portals and systems to gather accurate claim information. ● Stay current on payer policies, guidelines, and updates.
• Maintain accurate and complete documentation for all account activity. ● Participate in audits or quality reviews as needed.

• Identify recurring issues impacting payment delays (e.g., coding errors, authorization issues, payer trends).
• Communicate escalated or complex issues to Team Leads or Management. Providing feedback to leadership or upstream teams (charge entry, coding, front-end) to prevent future issues.
• Contribute to process improvement initiatives to enhance A/R performance. ● Partner with internal teams to collaborate on resolving claim issues. ● Maintain HIPAA compliance when handling patient protected health information (PHI)

BACKGROUND AND SKILLS YOU WILL BRING...

• High School Diploma, GED or equivalent required
• CPC/CPB or other Healthcare RCM certification is highly preferred.
• ICD-10, CPT, and HCPCS coding knowledge & skills
• Minimum 2 to 3 years experience in AR follow up and denials management ● Minimum of 1 year of customer service/client relations and employee training experience ● Excellent computer skills with strong proficiency in web-based and SaaS applications

SUCCESS LOOKS LIKE...

• Take bold action and ownership: Embrace an aggressive, proactive approach to drive progress and achieve impactful results.
• Deliver results with purpose: Focus on outcomes as much as strategy, ensuring every effort moves the needle forward.
• Adapt and thrive: Show flexibility and resilience in navigating the demands of a dynamic, evolving industry.
• Operate with humility and collaboration: Foster strong partnerships by working together with integrity and mutual respect.
• Innovate with confidence: Challenge conventional thinking, exploring creative solutions to complex problems.

HOW WE INVEST IN YOU...

• Competitive and comprehensive benefits: Coverage options to support the whole person, including full medical, dental, vision, and life insurance

o Generous employer sponsored subsidy towards employee's medical insurance premiums

o Azalea Health covers 100% of the premiums for Life AD&D and Long-Term Disability for all eligible full-time employees

• Balance and flexibility: Simple Paid Time Off (PTO) options. You earn your time, use it as you choose.
• Economic opportunity : Competitive total rewards package that offers competitive pay and advancement opportunities

Azalea Health's EEO Statement

Azalea Health is an Equal Opportunity Employer committed to creating a diverse and inclusive workforce where our employees excel based on merit, qualifications, knowledge, ability, and job performance. We embrace and encourage our employees' differences in age, color, disability, ethnicity, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socioeconomic status, veteran status, and any other characteristics protected by federal, state, and local laws that make our employees unique.