Lead Accounts Receivable Claims Specialist

🔥 0 minutes ago

🦀 Maryland – Remote

🦀 Maryland – Remote

💵 $21 - $31 / hour

⏰ Full Time

🟠 Senior

💰 Accounts Receivable

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University of Maryland Faculty Physicians

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

📚 Education

🧘 Wellness

Healthcare • Education • Wellness

University of Maryland Faculty Physicians is a clinical group practice affiliated with the University of Maryland School of Medicine that provides a wide range of outpatient medical services, including dermatology, cardiology, ophthalmology, urgent care, facial plastic surgery, and medi-spa treatments. The organization operates multiple patient-facing clinics, offers patient portal services (MyChart), appointment scheduling, billing, and partners with the university for clinical education and faculty-led care.

📋 Description

• Lead and coordinate the daily workflow of the Accounts Receivable Claims team • Serve as the primary resource for staff regarding denial resolution, appeals, and payer-specific requirements • Stay current on payer policies and coverage guidelines and communicate changes to team members • Monitor accounts receivable work queues to ensure timely identification and resolution of payment denials • Review and resolve complex claim denials, underpayments, and reimbursement discrepancies • Identify payment denials through work queues and take appropriate action to resolve them • Communicate professionally with providers to obtain documentation or clarification needed to resolve denied claims • Resubmit corrected claims based on payer policies or provider direction • Prepare and submit appeals with supporting documentation to ensure proper claim adjudication • Stay current on appeal processes and requirements for assigned payer groups • Provide guidance and support to team members • Monitor department performance and identify denial trends • Collaborate with providers, payers, and leadership to maximize reimbursement and improve revenue cycle performance

🎯 Requirements

• High school diploma or equivalent required • Associate degree in Healthcare Administration, Business, or a related field preferred • Minimum 4–5 years of experience in medical billing, accounts receivable, or denial management • Minimum 1–2 years of leadership, supervisory, mentoring, or team lead experience preferred • Strong knowledge of medical insurance plans including commercial, Medicare, Medicaid, and Tricare • Advanced understanding of claims adjudication, denial management, appeals, and reimbursement methodologies • Familiarity with medical terminology and CPT/ICD-10 codes • Experience with practice management systems and EHR platforms • Strong knowledge of medical coding concepts and third-party payer operations • Excellent communication and customer service skills • Strong analytical, problem-solving, and critical-thinking abilities • Familiarity with Microsoft applications, including Word and Excel • Strong written and verbal communication skills • Excellent organizational skills to manage multiple tasks, priorities, and deadlines • Demonstrated ability to work as a team player in a collaborative medical practice environment • Ability to communicate and work well with co-workers through open and honest communication • Ability to effectively communicate orally and in writing with internal and external business professionals • Must be responsible, reliable, and able to carry out job functions with minimal supervision • Demonstrated leadership skills with the ability to mentor staff and drive departmental performance improvements