AR Specialist

Integrated Pain Management Medical Group, Inc.•Walnut Creek, CA

10d•$22 - $29•Remote

About The Position

The AR Follow-Up Specialist is responsible for timely and accurate follow-up of outstanding accounts receivable within the Revenue Cycle Management (RCM) department. This role primarily supports California Medicare and Commercial AR, with additional responsibility for Workers’ Compensation and Rehab services. The position ensures optimal reimbursement through proactive payer outreach, claim status monitoring, denial resolution, and coordination with billing, coding, and authorization teams. The AR Specialist plays a key role in reducing days sales outstanding (DSO), improving cash flow, and supporting denial prevention strategies across all payer types. This is a remote role.

Requirements

High school diploma or GED required
3+ years of AR follow-up experience with strong emphasis on California Medicare and Commercial billing
Working knowledge of Workers’ Compensation billing, including adjuster communication, state rules, medical necessity, and required documentation
Experience managing mixed payer AR inventories with competing timelines and requirements
Ability to work in a fast-paced environment, meet daily deadlines, and collaborate with cross-functional RCM teams
Experience with multiple EHR / Practice Management systems (IMS, NextGen, Athena, eClinicalWorks, or similar)
Basic understanding of NCCI edits and payer-specific billing guidelines
Strong verbal and written communication skills; excellent attention to detail
Advanced proficiency in Microsoft Excel (formulas, pivot tables) and solid skills in other Microsoft Office applications

Responsibilities

Perform timely follow-up on California Medicare, Commercial, and Workers’ Compensation claims to ensure prompt adjudication
Conduct direct outreach to commercial payers, Medicare contractors, WC adjusters, case managers, and employers to obtain claim status, authorization verification, and documentation requirements
Resolve claim rejections, underpayments, incorrect fee schedule applications, and missing documentation across payer types (clinical notes, C-4/C-9 forms, MMI/RTW documentation, etc.)
Track and manage Workers’ Compensation payer-specific timelines, including 30-day status cycles and state-mandated payment rules
Monitor claims for timely filing, medical necessity, eligibility discrepancies, coordination of benefits (COB), and modifier accuracy
Coordinate with authorization teams to confirm authorization validity and ensure required documentation is submitted prior to billing
Escalate delayed or complex cases to appropriate internal team members or external partners
Identify opportunities for appeal when claims are underpaid or incorrectly denied for Medicare, Commercial, and WC payers
Prepare and submit appeal letters, reconsideration requests, and supporting documentation
Identify and report recurring denial trends and collaborate with billing, coding, and authorization teams to prevent recurrence
Assumes other responsibilities as appropriate to the position and organizational needs