Accounts Receivable Specialist-Medicare, Customer Service Operations

Cardinal Health•Doral, FL

11d•$20 - $26

About The Position

The Accounts Receivable Specialist - Medicare is responsible for the timely follow-up and resolution of insurance claims. This role ensures accurate and efficient collection of outstanding balances from insurance payers, working to reduce aging accounts receivable and increase cash flow for the organization. This position is a Medicaid insurance associate on the revenue cycle management team.

Requirements

1-3 years of experience, preferred
High School Diploma, GED or equivalent work experience, preferred
Strong knowledge of insurance claim processing and denial management preferred.
Familiarity with Medicare, Medicaid, and managed care preferred.
Proficiency in billing software (e.g. Waystar, Noble House, etc.) and Microsoft Office Suite.
Excellent verbal and written communication skills.
Ability to work independently and manage time effectively.
Detail-oriented with strong analytical and problem-solving skills

Responsibilities

Review aging reports and work insurance accounts to ensure timely resolution and reimbursement.
Contact insurance companies via phone, portals, or email to check claim status, request reprocessing or escalate issues.
Analyze denials and underpayments to determine appropriate action (appeals, corrections, resubmissions).
Track and follow up on all submitted appeals until resolution.
Analyze explanation of benefits (EOBs) and remittance advice to determine the reason for denial or reduced payment.
Document all collection activities in the billing system according to departmental procedures.
Follow up on unpaid claims within payer-specific guidelines and timelines.
Coordinate with other billing team members, coders, and providers to resolve claim discrepancies.
Maintain up-to-date knowledge of payer policies, coding changes, and reimbursement guidelines.
Ensure compliance with HIPAA and all relevant federal/state billing regulations.
Flag trends or recurring issues for team leads or supervisors.
Meet daily/weekly productivity goals (e.g., number of claims worked, follow-ups completed).
Assist with special projects, audits, or other duties as assigned.