Accounts Receivable Specialist

🔥 16 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

💰 Accounts Receivable

🚫👨‍🎓 No degree required

👻 Ghost score 15%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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HighFive Healthcare

WebsiteLinkedInAll Job Openings

501 - 1000 employees

💼 Consulting

📣 Marketing

🏥 Healthcare

Consulting • Marketing • Healthcare

HighFive Healthcare is a comprehensive healthcare management company with over 60 years of experience in the industry. They specialize in various aspects of healthcare, including dental management, endodontics, and oral surgery. HighFive Healthcare offers a wide range of services, from billing and marketing to compliance and maintenance, positioning themselves as a versatile partner dedicated to enhancing the operational efficiency of healthcare providers, allowing them to focus on patient care.

📋 Description

• Manage HighFive’s Oral Surgery insurance accounts receivable process • Submit claims accurately and on time • Follow up on unpaid and denied claims • Work with insurance companies, healthcare payors, and patients to resolve billing discrepancies and issues • Investigate, appeal, and resolve denied or rejected claims • Clarify discrepancies with insurance companies and ensure proper reimbursement • Review and assess Explanation of Benefits (EOBs) at the claim level • Determine root causes of billing or claim submission issues and prevent recurrence • Correct and rebill claims based on denials using standardized processes and procedures • Follow up on unresolved claims through system resources, clearinghouses, payer portals, or calls to payors • Assess whether appeals are required and track appeals for timely payment and resolution • Identify recurring denial patterns and report them to management • Communicate with team members, payors, patients, and other relevant parties • Keep current with internal processes, industry standards, and government regulations related to denial management • Participate in special projects or perform additional duties as required • Meet or exceed required accounts per day • Achieve department goals for net collection rates and denied-claim resolution

🎯 Requirements

• Oral Surgery billing experience required • Denial/Claim OR AR Experience with TMJ (temporomandibular joint/orthognathic surgery) preferred • High school diploma or equivalent; associate or bachelor’s degree in healthcare, business, or a related field preferred • Minimum of 2 years of experience in healthcare billing and accounts receivable • Knowledge of medical insurance plans, billing procedures, and healthcare reimbursement processes • Proficiency with Electronic Health Record (EHR) systems and billing software • Dental billing experience preferred but not required • Working knowledge of excel and system workflows • Prior experience with mid or large-scale healthcare business office of 100 or more providers preferred • Strong attention to detail with the ability to accurately review and process claims • Excellent communication and problem-solving skills • Ability to work independently and manage multiple tasks simultaneously • Knowledge of HIPAA and other healthcare compliance regulations