Accounts Receivable Escalations Specialist

Allied Digestive Health•West Long Branch, NJ

About The Position

THE ACCOUNTS RECEIVABLE ESCALATIONS SPECIALIST IS RESPONSIBLE FOR MANAGING COMPLEX, AGED, HIGH-RISK, AND HIGH-DOLLAR ACCOUNTS REQUIRING ADVANCED INTERVENTION TO DRIVE PAYMENT RESOLUTION. THIS ROLE SERVES AS THE FINAL OPERATIONAL ESCALATION LAYER WITHIN THE REVENUE CYCLE MANAGEMENT (RCM) FUNCTION, FOCUSING ON REMOVING PAYMENT BARRIERS, ACCELERATING CASH RECOVERY, AND PREVENTING LONG-TERM AGING EXPOSURE. THE ESCALATIONS SPECIALIST ENSURES CLAIMS MOVE FORWARD CLEANLY THROUGH THE REVENUE CYCLE TOWARD FINANCIAL RESOLUTION WHILE IDENTIFYING SYSTEMIC BREAKDOWNS IMPACTING REIMBURSEMENT PERFORMANCE.

Requirements

Revenue ownership mindset and Escalation judgment
Problem solving and organizational skills with Critical thinking.
Reliability, Accuracy and Efficiency when dealing with patients or third-party payors.
Persistence and negotiation ability
Operational accountability
Ability to work independently with minimal supervision and be result oriented.
Ability to use good judgments in highly emotional and demanding situations.
Ability to react to frequent changes in duties and volume of work.
Excellent oral and written communication skills.
Effective interpersonal skills, including the ability to promote teamwork.
Strong problem-solving skills.
Ability to ensure a high level of customer satisfaction including employees, patients, physicians, and external stakeholders.
Maintains confidentiality of sensitive information
High School Diploma
3+ years of healthcare Accounts Receivable experience
Advanced payer follow-up and denial resolution expertise
Knowledge of reimbursement methodologies
Strong analytical and investigative skills
Ability to manage complex account portfolios

Nice To Haves

Escalations or complex A/R specialization
Multi-specialty or MSO experience
Appeals and payer negotiation experience
Experience with Athena, Epic, eClinicalWorks, or similar PM systems

Responsibilities

Manage accounts aged 70+ days or identified as payment risk.
Resolve complex payer issues requiring advanced research.
Financial impact awareness
Prioritize high-balance accounts impacting cash flow.
Perform high-level payer outreach and escalation conversations.
Coordinate resolution for stalled, rejected, or repeatedly denied claims.
Drive accounts to final disposition (paid, adjusted, or escalated legally).
Lead second-level and executive appeals.
Execute targeted recovery strategies on aged inventory.
Identify recurring revenue cycle breakdowns and provide structured feedback.
May be required to conduct and/or participate in training sessions at the office level.
Participates in special projects as assigned.
Any other duties assigned.