EHR)

Raintree Systems, Inc.

18h•Remote

About The Position

The Accounts Receivable Specialist ensures accurate, compliant, and timely billing and appropriate reimbursement for multispecialty medical professional services from insurance payers and patients. The role involves collecting unpaid patient accounts, rebilling, posting payments, processing contractual write-offs and adjustments, and handling appeals in accordance with applicable multi-state and federal insurance regulations. The position is fully remote and may be performed from Alabama, Arizona, Florida, Georgia, Indiana, Kansas, Massachusetts, Michigan, Mississippi, North Carolina, Nevada, Oregon, Pennsylvania, South Carolina, Tennessee, or Texas.

Requirements

High school diploma, GED, or equivalent work experience.
At least 7 years of experience.
Proficiency in Microsoft Office applications, including Outlook, Excel, and Word, and Google applications.
Ability to perform arithmetic using whole numbers, common fractions, and decimals.
Ability to define problems, collect data, establish facts, and identify trends.
Ability to exercise good judgment and escalate issues appropriately.
Strong written and verbal communication skills; dependability, reliability, and self-direction.
Ability to work well in a team and independently, with outstanding interpersonal skills.
Strong organizational skills, attention to detail, and ability to prioritize tasks, complete work, and meet deadlines.
Ability to promote a positive influence within the team, department, and company.

Nice To Haves

Experience in medical insurance claims billing.

Responsibilities

Prepare and resubmit clean claims to insurance companies electronically or by paper in accordance with payer guidelines and contract requirements.
Analyze and correct first-pass rejected claims for complete and accurate information before second-pass submission.
Research and conduct primary and secondary billing claim-status follow-up for assigned insurance plans.
Review, evaluate, and process claim appeals, submitting them to insurance carriers with complete and accurate supporting documentation.
Research and recommend customer account adjustments or write-offs to the Manager based on account collectability.
Identify and report claims problems, errors, and discrepancies to management to help resolve billing trends promptly.
Generate and submit monthly patient balance-due statements based on explanations of benefits from insurance carriers.
Review patient accounts, identify delinquent accounts, and collect overdue payments.
Answer patient questions about billing and payments.
Investigate patient inquiries or complaints, or direct them to the appropriate staff member.
Ensure adherence to HIPAA guidelines, company HR policies, standard operating procedures, and other corporate initiatives.