Remote Medical Accounts Receivable Specialist

We are looking for a remote detail-oriented Medical Accounts Receivable Specialist to support revenue cycle operations for a healthcare organization. This position focuses on resolving claim denials, recovering outstanding balances, and improving reimbursement outcomes across a variety of payers. The ideal candidate will bring strong medical billing knowledge, sound judgment in payer follow-up, and the ability to work accurately with account documentation, reporting, and appeals, and averages about 100 patient accounts per day. Responsibilities:

• Investigate denied, rejected, and partially reimbursed claims to determine the cause of nonpayment and drive timely resolution.
• Take corrective action on accounts by submitting claim adjustments, preparing reconsiderations, gathering needed documentation, and filing appeals in line with payer requirements.
• Manage assigned receivables by reviewing aging reports, prioritizing high-risk accounts, and working toward monthly collection and resolution goals.
• Communicate with insurance carriers to verify claim status, clarify adjudication outcomes, and escalate unresolved issues when additional review is required.
• Examine differences between submitted charges and payer payments to identify billing inconsistencies, underpayments, and reimbursement discrepancies.
• Partner with billing, coding, and clinical teams to correct claim edits, address authorization concerns, and resolve denial issues related to coding or documentation.
• Maintain complete account notes and follow-up records so all activity is accurately documented for audit readiness and operational visibility.
• Use electronic medical record and revenue cycle systems, including NX (MyAvatar) and Aura – Sigmund, to review account activity, claim history, and supporting encounter information.
• Prepare and share reporting on denial categories, payer behavior, and accounts receivable performance to help identify trends and support process improvement efforts.

Qualifications:

• Experience with NX (MyAvatar) or Aura – Sigmund is required.
• Experience working in medical accounts receivable, medical billing, or denial resolution within a healthcare environment.
• Demonstrated ability to research and resolve insurance denials, underpayments, and rejected claims across commercial payers.
• Knowledge of accounts receivable workflows, collections activity, cash applications, and billing functions related to healthcare claims.
• Familiarity with payer guidelines, appeals processes, and compliance standards governing claim submission and reimbursement.
• Ability to interpret explanation of benefits information, analyze account discrepancies, and determine appropriate next steps for resolution.
• Strong written and verbal communication skills with the ability to document follow-up clearly and prepare accurate appeal correspondence.

Compensation $25.00-$27.00 Hourly

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