The specialist will review claims for accuracy, resolve denials, and manage aged accounts receivable to ensure timely payments. They are also responsible for verifying patient eligibility and documenting all follow-up activities within the practice management system.
This is a remote position.
Job Summary
RCM Staff BPO is hiring a full-time Accounts Receivable (A/R) and Denial Management Specialist to support a multi-specialty physician group based in Florida.
You will review claims for accuracy before submission, work aged A/R, and resolve denials so the practice gets paid faster and with fewer rejections. This role requires strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans, especially Medicare.
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
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