Medical Accounts Receivable Specialist

Job Locations US-Remote
ID 2023-2060
Location Status
Position Type
Regular Full-Time


Job Summary:

  • The Medical Accounts Receivable (“AR”) Specialists are primarily responsible for analyzing collections, resolving non-payables, and handling bill inquiries for more complex issues. AR Representatives are responsible for insurance payer follow-up ensuring claims are paid according to client contracts. Complies with all applicable laws regarding billing standards


Essential Functions and Tasks: 

  • Follows up on claim rejections and denials to ensure appropriate reimbursement for our clients
  • Process assigned AR work lists provided by the manager in a timely manner
  • Write appeals using established guidelines to resolve claim denials with a goal of one contact resolution
  • Identified and resolved denied, non-paid, and/or non-adjudicated claims and billing issues due to coverage issues, medical record requests, and authorizations
  • Recommend accounts to be written off on Adjustment Request
  • Reports address and/or filing rule changes to the manager
  • Check system for missing payments
  • Properly notates patient accounts
  • Review each piece of correspondence to determine specific problems
  • Research patient accounts
  • Reviews accounts and to determine appropriate follow-up actions (adjustments, letters, phone insurance, etc.)
  • Processes and follows up on appeals. Files appeals on claim denials
  • Scan correspondence and index to the proper account
  • Inbound/outbound calls may be required for follow up on accounts
  • Route client calls to the appropriate RCM
  • Respond to insurance company claim inquiries
  • Communicates with insurance companies for status on outstanding claims
  • Meet established production and quality standards as set by Ventra Health
  • Performs special projects and other duties as assigned 

Education and Experience Requirements: 

  • High School Diploma or GED
  • At least one (1) year in data entry field and one (1) year in medical billing and claims resolution preferred
  • AAHAM and/or HFMA certification preferred
  • Experience with offshore engagement and collaboration desired


Knowledge, Skills, and Abilities: 

  • Intermediate level knowledge of medical billing rules, such as coordination of benefits, modifiers, Medicare, and Medicaid and understanding of EOBs
  • Become proficient in use of billing software within 4 weeks and maintain proficiency
  • Ability to read, understand, and apply state/federal laws, regulations, and policies
  • Ability to communicate with diverse personalities in a tactful, mature, and professional manner
  • Ability to remain flexible and work within a collaborative and fast paced environment
  • Basic use of computer, telephone, internet, copier, fax, and scanner
  • Basic touch 10 key skills
  • Basic Math skills   
  • Understand and comply with company policies and procedures
  • Strong oral, written, and interpersonal communication skills
  • Strong time management and organizational skills
  • Strong knowledge of Outlook, Word, Excel (pivot tables), and database software skills

Base Compensation:   

  • Base Compensation for this position: $16.00 - $20.00 per hour
  • Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons
  • This position is also eligible for discretionary performance bonuses in accordance with company policies



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