Accounts Receivable Specialist

NextCare•Tempe, AZ

About The Position

The accounts receivable specialist will be responsible for maintaining the organization's financial health, with a focus on timely and accurate resolution of outstanding medical claims. The accounts receivable specialist is required to have a deep understanding of the medical billing lifecycle, advanced knowledge or payer guidelines, and a proven ability to reduce accounts receivable aging through proactive follow up and denial management.

Requirements

Minimum of High School diploma or equivalent.
Minimum of 5 years of experience in medical billing or accounts receivable with a strong emphasis on insurance claim resolution and denial management.
In-depth understanding of medical billing and coding principles (CPT, ICD-10, HCPCS) and payer reimbursement methodologies.
Proficiency with medical billing software; experience with NextGen Billing strongly preferred. Waystar Clearinghouse expertise required.
Strong ability to interpret EOBs, remittance advice, and payer correspondence to resolve complex claim issues.
Exceptional accuracy in data entry, financial reconciliation, and documentation.
Effective written and verbal communication skills to interact with payers, internal teams, and external stakeholders in a professional manner.

Nice To Haves

experience with NextGen Billing

Responsibilities

Verify patient insurance eligibility and benefits before claim submission
Review and analyze clearinghouse rejections and identify root causes for rejected claims.
Monitor and follow up on unpaid and denied medical claims across a variety of payers (Commercial, Medicare, Medicaid, Workers Comp Carriers, etc.) to ensure timely reimbursement.
Research, analyze, and resolve claim denials and underpayments by identifying root causes, correcting errors, submitting appeals, or providing additional documentation as needed.
Reconcile accounts receivable by posting adjustments and resolving discrepancies to maintain accurate financial records.
Generate and analyze A/R reports to identify patterns in denials, reimbursement delays, or system inefficiencies, and recommend process improvements.
Partner with billing, coding, and compliance teams to ensure claims are processed accurately and efficiently.
Maintain strict adherence to HIPAA regulations, payer-specific guidelines, and company policies to ensure data integrity and patient confidentiality
Treats patients and co-workers consistent with the NextCare Mission Statement, Vision, Values and Performance Standards.
Performs other related duties as assigned or described in Company policy.