Accounts Receivable (A/R) and Denial Management Specialist

This is a remote position.

Key Responsibilities

• Review pending and unbilled claim buckets in the practice management system for accuracy before submission
  
• Correct eligibility, wrong-payer, demographic, and coding-related errors so claims are paid on the first submission
  
• Verify patient eligibility and confirm the correct primary and secondary insurance
  
• Follow up on unpaid, underpaid, and aged claims through payer portals and phone calls
  
• Research denials, identify the root cause, and submit corrected claims, reconsiderations, or appeals
  
• Check claim status and resolve issues using Medicare, Availity, and UnitedHealthcare portals
  
• Document all follow-up activity and next steps clearly in the practice management system
  
• Report recurring denial trends and payer issues to the billing manager
  
• Work alongside the practice’s in-house A/R team and meet daily productivity targets
  
• Protect patient information and follow HIPAA requirements
  

Qualifications

• At least 2 years of experience with U.S. healthcare A/R follow-up and denial management
  
• Experience reviewing claims for accuracy and resolving eligibility and payer errors
  
• Familiarity with commercial insurance and government health plans, including Medicare
  
• Experience using payer portals and insurance websites
  
• Strong written and spoken English
  
• Excellent attention to detail and follow-up skills
  
• Ability to work independently and manage multiple patient accounts
  
• Reliable internet connection and a suitable remote workspace
  

Preferred Qualifications

• Experience using AdvancedMD
  
• Experience using First Coast SPOT (Florida Medicare), Availity, and the UnitedHealthcare provider portal
  
• Experience supporting internal medicine, hospitalist, wound care, or pain management practices
  
• Familiarity with Florida insurance plans
  
• Experience working a Medicare-heavy A/R and handling Medicare reconsiderations and redeterminations
  

Schedule

• Full-time position
  
• Must be available during Eastern Time business hours
  
• Final schedule will be determined based on practice needs
  

Work Arrangement

• Remote
  
• Philippines-based applicants preferred