Accounts Receivable Specialist

Position SummaryThe Lead Aging Accounts Receivable Specialist oversees the follow-up and resolution of outstanding patient and payer balances to support the financial health of Park West Health System. This role is responsible for monitoring aging reports, prioritizing high-risk accounts, and leading complex claim resolution efforts to ensure timely reimbursement and reduction of uncompensated care.Working closely with the Director of Business Operations, billing team members, and external payers, the Lead Specialist serves as a subject matter expert on denial management, payer trends, and accounts receivable workflows. The role provides guidance and support to team members, identifies process improvement opportunities, and helps ensure compliance with payer requirements and organizational policies.The Lead Aging Accounts Receivable Specialist also collaborates with front-end and clinical teams to address root causes of billing delays and promotes efficient revenue cycle practices that align with Park West’s operational goals and commitment to service excellence.Essential FunctionsMonitor aging reports to identify delinquent accounts and take appropriate action to collect outstanding balanceServes as an advocate to troubleshoot problems within the Medical Registration area that can cause billing delay in reimbursementResponsible for the daily charge entry of the Billing Department for all patient accounting and related functions. This includes accounts receivable, billing, credit, and collections.Prepare and submit billing to insurance companies or other payersFollow up on delinquent claims and past due invoicesManage Medicare and Medicaid claimsUses coded data to produce claims to insurance companiesReviewing and appealing denied and unpaid claimsVerifies patients insurance coverage as well as answers patients billing questionsWorks and maintains assigned receivable through work queues, age trail balance reports (ATB’s), and special projects to achieve established departmental goals through resolution of outstanding account balances and reduction of uncompensated care.Ensures correct processing of outstanding insurance claims by:Interpreting insurance payer responsesRequesting account level adjustmentsSubmitting appeals and claims reconsiderationsEvaluating financial responsibility of patientsResolving insurance denials and claim rejectionPerforming insurance verificationAssists with Front Desk Registrar duties as needed to support clinic operations and ensure seamless patient flow.Core Responsibilities and Organizational ExpectationsIn addition to role responsibilities, every employee has the following responsibilities as a part of their employment:Provides courteous, responsive, and service-oriented support to patients, visitors, and colleagues. Promotes a respectful and welcoming environment, communicates clearly, and works collaboratively to support team and organizational goals.Performs all duties in a manner consistent with Park West Health System’s mission, vision, and organizational values, demonstrating a commitment to quality care, respect, and service excellence.Adheres to all applicable federal, state, and local regulations, as well as organizational policies and procedures, including HIPAA, privacy, and security standards.Follows all infection control, workplace safety, and risk management protocols. Participates in quality improvement and performance initiatives as appropriate to the role.Maintains professionalism, reliability, and accountability in attendance, performance, and communication; completes required trainings; participates in staff meetings and organizational initiativesPerforms other duties on an as-needed basis.QualificationsHigh school diploma or equivalent required.Minimum of five (5) years of experience in a medical billing or revenue cycle environment required.Minimum of five (5) years of experience in customer service, patient relations, or a related healthcare support role required.Experience working in a Federally Qualified Health Center (FQHC) or community health setting preferred.Experience using electronic health record (EHR) and practice management systems required.Working knowledge of medical terminology obtained through formal training or relevant work experience required.Proficiency with computer systems, including electronic billing and practice management platforms, required.SkillsAdvanced knowledge of accounts receivable follow-up, denial management, and payer resolution strategiesStrong analytical skills with the ability to identify trends, root causes, and process improvement opportunitiesAbility to interpret explanation of benefits (EOBs), remittance advice, and payer correspondence accuratelyExcellent organizational and time-management skills with the ability to manage large volumes of accounts and competing prioritiesStrong problem-solving skills with the ability to independently resolve complex billing issues #J-18808-Ljbffr