Accounts Receivable Specialist – Medical Billing Experience

🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

💰 Accounts Receivable

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

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Netsmart

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1973

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

Netsmart is a leading provider of comprehensive EHR solutions tailored for a wide range of care settings, especially in behavioral health, addiction treatment, autism, geriatrics, and intellectual and developmental disabilities. The company offers a range of software products that streamline operations, enhance care coordination, and promote value-based care across healthcare communities. In addition to EHRs, Netsmart provides technology solutions for care coordination, telehealth, population health management, and revenue cycle management, aiming to support the delivery of integrated and person-centered care. Their solutions are used in a variety of sectors including human services, post-acute care, and public health, making Netsmart a significant player in the healthcare technology industry.

📋 Description

• Manage a portfolio of outstanding insurance accounts receivable, ensuring timely follow-up and resolution of unpaid or underpaid claims • Perform end-to-end denial management, including researching claim denials, identifying root causes, submitting appeals, and securing appropriate reimbursement • Analyze denial patterns and reimbursement trends to identify opportunities for process improvement and revenue recovery • Contact insurance carriers via phone, email, fax, payer portals, and written correspondence to resolve claim issues and payment delays • Investigate and resolve claim edits, rejections, authorization issues, coding discrepancies, and payer-specific reimbursement concerns • Follow up on aged accounts and claims with no response from insurance carriers while maintaining productivity and quality standards • Use Microsoft Excel to track accounts, analyze payer trends, manage work queues, create reports, and maintain denial inventories • Use Microsoft Outlook extensively for communication with payers, clients, and internal stakeholders regarding claim resolution activities • Review and apply current federal, state, Medicare, Medicaid, and payer-specific billing regulations • Handle Electronic Data Interchange (EDI) transactions, including reconciliation of carrier submissions, clearinghouse edits, and rejection reports • Leverage RPA tools and AI-assisted workflows to enhance efficiency, automate routine follow-up activities, and improve claim resolution outcomes • Maintain detailed documentation of account activity and claim resolution efforts

🎯 Requirements

• High school diploma or GED • Minimum of 1 year of healthcare accounts receivable, medical billing, or denial management experience • Demonstrated experience researching and resolving insurance claim denials and payer reimbursement issues • Advanced Microsoft Excel skills, including VLOOKUPs/XLOOKUPs, Pivot Tables, filters, formulas, and spreadsheet management • Strong proficiency in Microsoft Outlook, including managing high-volume email communications and claim follow-up correspondence • Understanding of insurance reimbursement processes, claim adjudication, Medicare, Medicaid, and commercial payer requirements • Strong analytical, critical thinking, and problem-solving skills • Excellent verbal and written communication skills • Demonstrated ability to manage productivity metrics and work independently in a fast-paced environment • All applicants must be legally authorized to work in the United States • Netsmart does not provide work visa sponsorship for this position • Preferred: Experience in behavioral health, post-acute care, home health, long-term care, or specialty healthcare billing • Preferred: 2+ years of insurance AR follow-up and denial management experience • Preferred: Collections experience within a healthcare revenue cycle environment • Preferred: Experience preparing and submitting formal appeals to insurance carriers • Preferred: Working knowledge of medical billing systems such as Medic, IDX, Avatar, Tier, Medical Manager, or similar platforms • Preferred: Experience with automation tools, AI-enabled workflows, or revenue cycle technology solutions

🏖️ Benefits

• Equal employment and advancement opportunities • Pre-employment background check and drug screen provided at Netsmart’s sole expense