AR Follow Up Specialist en EngageMED Inc

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