Accounts Receivable Specialist

Accounts Receivable Specialist Location: REMOTE Entity: Alliance Health System Reports To: Director of Collections *Out of Network experience required* As a Medical Billing & Collections Specialist , you'll play a key role in helping our healthcare providers focus on what matters most—caring for patients—by ensuring claims are processed accurately, denials are resolved efficiently, and reimbursements are maximized In this role, you'll investigate and resolve denied or underpaid claims, follow up with insurance companies and patients, and help keep revenue cycle operations running smoothly. You'll collaborate with a team that believes every challenge is an opportunity to improve, every process can be optimized, and every team member contributes to better patient outcomes Summary of Responsibilities Denial Management : Investigate and resolve claim denials by appealing, resubmitting, or making necessary corrections. Follow-Up : Conduct regular follow-ups with insurance companies and patients to ensure timely payment of outstanding balances Compliance : Stay updated on industry regulations and compliance requirements to ensure adherence in billing practices. Basic Requirements: Claim Resolution and Reimbursement: Demonstrate strong desire and commitment to resolving medical claims and effectively collecting insurance reimbursements Organizational Skills: Must possess excellent organizational skills with thorough attention to detail in handling accounts receivable processes. Independence and Collaboration: Ability to work independently and collaboratively within a group, fostering a team-oriented and efficient work environment. Communication Skills: Exceptional written and verbal communication skills are essential, showcasing the ability to interact professionally and effectively with both internal and external stakeholders Experience Requirements: Medical Billing/Collections Professional: Proven experience in resolving denied/underpaid claims and conducting thorough follow-ups with insurance providers to maximize reimbursements. Diverse Responsibilities: Extensive experience in various aspects of medical billing and collections, including but not limited to claim submissions, attorney follow-ups, and other duties relevant to the field. Specialized Expertise: Prior experience in Conservative Therapy (Physical Therapy, Occupational Therapy, and Chiropractic), Medical (Physical Medicine and Rehabilitation, with expertise in Pain Management, Orthopedic, and Vascular disciplines), or Patient Accounts (Self Pay) is preferred. Excel/Google Sheets: Demonstrated proficiency in utilizing Excel and Google Sheets for data analysis and reporting purposes. Out of Network Experience: Proven track record of handling Out of Network billing processes effectively. Payer Portals: Familiarity with various Payer Portals for streamlined communication and efficient claims processing. Insurance Knowledge: Extensive experience with all Major Medical Insurance Providers, Work Comp, and Motor Vehicle claims is preferred. Bilingual Skills: Fluency in Spanish is a plus. Job Type: Full-Time Monday-Friday Remote Benefits 401(k) matching Medical, Dental & Vision Paid Time Off Sick Time Paid Holidays Background Check Requirement: Employment is contingent upon the successful completion of a background check, which may include verification of employment history, education, criminal records, and other relevant information as permitted by law.