Job Description

Position: AR Follow Up Specialist

Department: Revenue Cycle-9002

FLSA Status: Full Time; Exempt

Reports To: Billing Office Manager

JOB DESCRIPTION -

EngageMED is looking for a dedicated and meticulous

AR Specialist

to join our dynamic revenue cycle team.


The Accounts Receivable Specialist is a critical role responsible for the timely follow-up, collection, and resolution of outstanding medical claims from government and commercial payers. You will be instrumental in analyzing denial trends, preparing effective appeals, and maximizing our cash flow. If you have a deep understanding of the full medical billing lifecycle and thrive on solving complex claim issues, we want to hear from you.

Key Responsibilities

Claim Follow-Up:

Proactively manage and work aging reports, contacting insurance companies (e.g., Medicare, Medicaid, and commercial plans) to resolve unpaid or denied claims.

Denial Management:

Identify, analyze, and resolve root causes of denials (coding, authorization, medical necessity, etc.).

Appeals Process:

Prepare and submit clear, compelling appeals with necessary clinical documentation to secure payment.

Payment Posting & Reconciliation:

Review and post electronic and manual Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs), ensuring accuracy.

Payer Research:

Stay current on payer policy changes and reimbursement guidelines to minimize future claim errors.

Reporting:

Track and report on key AR metrics, identifying trends and recommending process improvements.

Patient Accounts:

Handle complex patient inquiries related to billing and outstanding balances when escalated from customer service or the clinic.

Qualifications

Required Skills & Experience

3+ years

of dedicated experience in medical billing, specifically focused on Accounts Receivable and denial management. In-depth knowledge of healthcare claim forms (CMS-1500) and electronic submission processes. Proficiency in interpreting EOBs and ERAs. Solid understanding of medical terminology, CPT, ICD-10, and HCPCS coding principles. Experience utilizing an electronic medical record (EMR) system and medical billing software. (E-Clinical Works, Valant, Wound Expert) Exceptional organizational skills and keen attention to detail.

We offer a competitive compensation package, comprehensive benefits, and a supportive team culture that values expertise and growth.

Medical, Dental, and Vision Insurance 401(k) retirement plan with company match Generous Paid Time Off (PTO) and paid holidays * Opportunities for professional development and training