Revenue Cycle AR Specialist

Azalea Health Innovations Inc • Sandy Springs, GA

1d

About The Position

The Revenue Cycle Accounts Receivable (A/R) Specialist manages and resolves outstanding accounts to support timely reimbursement and optimal cash flow. The role analyzes aged receivables, follows up with payers, and addresses claim issues that delay payment. It focuses on reducing aging balances by investigating denials, underpayments, and unpaid claims, identifying root causes, and implementing corrective actions. Working with internal teams and payers, the specialist helps improve revenue cycle performance through accurate follow-up, reduced revenue leakage, and continuous process improvement.

Requirements

• High school diploma, GED, or equivalent.
• Knowledge and skills in ICD-10, CPT, and HCPCS coding.
• A minimum of 2 to 3 years of experience in A/R follow-up and denials management.
• A minimum of 1 year of customer service/client relations and employee training experience.
• Excellent computer skills and strong proficiency with web-based and SaaS applications.

Nice To Haves

• CPC, CPB, or another healthcare RCM certification is highly preferred.

Responsibilities

• Monitor A/R aging reports and prioritize high-value or high-risk accounts.
• Manage and prioritize assigned A/R work queues, focusing on accounts aged 30, 60, and 90+ days to prevent claims from aging beyond 91+ days.
• Follow up promptly with insurance payers by phone, portals, or correspondence to resolve unpaid or underpaid claims.
• Document follow-up activities accurately and promptly, maintaining complete account activity records.
• Investigate denied or underpaid claims to determine root causes.
• Correct claim errors and resubmit claims or file appeals as appropriate.
• Identify denial patterns and escalate trends for process improvement.
• Research and resolve payment discrepancies, including partial payments and contractual variances.
• Identify and escalate potential payer issues, system errors, and configuration gaps.
• Meet productivity benchmarks and KPIs while maintaining work quality and accuracy.
• Ensure work complies with payer regulations, billing guidelines, and internal SOPs.
• Communicate with payer representatives to obtain claim status, resolve issues, and expedite payment.
• Navigate payer portals and systems to gather accurate claim information, and stay current on payer policies, guidelines, and updates.
• Participate in audits or quality reviews as needed.
• Identify recurring issues that affect payment timing, such as coding errors, authorization issues, and payer trends.
• Communicate escalated or complex issues to Team Leads or Management and provide feedback to leadership or upstream teams, including charge entry, coding, and front-end teams.
• Contribute to process improvement initiatives and collaborate with internal teams to resolve claim issues.
• Maintain HIPAA compliance when handling patient protected health information (PHI).

Benefits

• Medical, dental, vision, and life insurance coverage options.
• Employer-sponsored subsidy toward employee medical insurance premiums.
• 100% employer-paid premiums for Life AD&D and Long-Term Disability for eligible full-time employees.
• Paid Time Off (PTO) options; employees earn their time and may use it as they choose.
• Competitive total rewards package, competitive pay, and advancement opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED