Accounts Receivable Specialist

Aston Carter•North Haven, CT

3d•$24 - $28•Onsite

About The Position

The Accounts Receivable Specialist plays a vital role in the hospital’s revenue cycle by managing the full spectrum of billing processes, payment collections, insurance reimbursement, and denial resolution. This position requires a strong understanding of healthcare billing practices, payer requirements, and revenue cycle workflows. The specialist works collaboratively with internal teams to ensure claims are billed correctly, denials are efficiently resolved, and revenue is collected in a timely manner. By supporting process improvement, communication across departments, and patient billing clarity, this role helps ensure the financial health of the organization and a smooth experience for patients.

Requirements

Healthcare A/R experience
Accounts receivable
Invoicing
Reconciliation
Billing software
Billing management
High school diploma and a minimum of three years experience in a hospital patient accounts environment or medical office setting required.
Thorough understanding of third-party insurance carriers, standard 835 remittance advice codes, contractual adjustments, and payer payment and reimbursement policies.
Excellent analytical and organizational skills and familiarity with basic medical terminology.
Knowledge of EHR systems (Meditech, Epic, Cerner) and payment portals.
Proficiency in Microsoft Office Suite.

Nice To Haves

Associate Degree in a business-related field or equivalent from a two-year technical school preferred.
2+ years of experience in cash posting or revenue cycle operations within a healthcare setting preferred.
Certified Revenue Cycle Representative (CRCR) preferred.

Responsibilities

Ensure claims are accurately submitted to insurance payers, ensuring compliance with payer-specific requirements.
Monitor outstanding claims to identify payment issues and take appropriate actions to ensure timely resolution and accurate reimbursement from third-party payers or patients.
Analyze denials and underpayments, initiating appeals or corrected claims when necessary.
Track A/R aging, denial trends, and reimbursement effectiveness, reporting issues to leadership as needed.
Ensure accurate billing and timely resolution of issues to maximize the patient experience.
Assist with complex patient inquiries related to insurance billing and claim status.
Support processes that improve the overall patient financial experience.
Evaluate workflows and denial trends to identify areas for operational improvement.
Recommend changes to billing/collection practices or systems that enhance claim acceptance and reduce rework.
Assist with testing and updates to software and payer portals.
Perform root cause analysis to increase the clean claim rate and reduce first pass denials.
Contribute to departmental goals, KPIs, and strategic initiatives to improve revenue cycle performance.
Coordinate with all revenue cycle teams to resolve claim issues and prevent billing errors and denials.
Communicate with payers to ensure appropriate payment.
Maintain positive working relationships with internal departments, third-party payers, and patients.
Participate in team meetings and contribute to a culture of continuous improvement and accountability.