Revenue Cycle Specialist II - AR & Denials Follow-Up

E.N.T. Specialty Partners•Irving, TX

1d•Onsite

About The Position

This position manages and performs insurance accounts receivable (AR) follow-up, including claim-status review, denial resolution, reconsiderations, appeals, and resolution of outstanding insurance balances. The role requires a strong understanding of insurance billing and reimbursement processes and the ability to independently identify and resolve claim issues. ENT experience is preferred but not required. The specialist works assigned AR inventory according to established priorities, productivity expectations, and follow-up timeframes; maintains accurate account and claim information and documentation; and responds to correspondence and payer inquiries promptly. The position also involves coordinating with providers and internal departments and providing respectful assistance to patients and families regarding insurance balances. The role requires handling patient information in accordance with HIPAA and maintaining confidentiality of patient and company information. Applicants must currently reside in Texas, Maryland, Virginia, or Pennsylvania.

Requirements

Minimum of 3–5 years of hands-on experience in medical insurance AR follow-up.
Demonstrated experience with insurance claim follow-up, denials, reconsiderations, and appeals.
Strong understanding of insurance payer requirements, claim processing, timely filing, authorizations, eligibility, coding-related denials, medical records requests, and other common reimbursement issues.
Experience researching unpaid and denied claims, determining the appropriate next action, and accurately documenting follow-up activity.
Ability to work independently and manage a high-volume AR workload while meeting established productivity and quality expectations.
Must currently reside in Texas, Maryland, Virginia, or Pennsylvania.

Nice To Haves

ENT experience.

Responsibilities

Perform timely and thorough insurance AR follow-up on outstanding claims and balances.
Monitor claim status and contact insurance carriers to resolve unpaid, underpaid, and denied claims.
Research denials, reconsiderations, appeals, and payer requests for additional information or medical records.
Identify the root cause of claim denials and determine the appropriate resolution, such as corrected claims, reconsiderations, appeals, or additional documentation.
Review claim history, payments, adjustments, charges, and account activity within the EHR to ensure accurate account resolution.
Review and interpret insurance correspondence, Explanation of Benefits (EOBs), remittance information, and payer responses.
Coordinate with providers and internal departments when additional information, documentation, coding clarification, or other action is needed to resolve a claim.
Maintain accurate and detailed documentation of AR follow-up activity and payer communications.
Follow HIPAA requirements when handling patient information and providing or requesting medical records.
Accurately enter and maintain account and claim information within the computer system.
Work assigned AR inventory according to established priorities, productivity expectations, and follow-up timeframes.
Respond to account-related correspondence and payer inquiries in a timely manner.
Provide professional and respectful customer service to patients and their families when assistance is needed regarding insurance balances.
Work independently and as part of a team to meet departmental goals.
Maintain confidentiality of patient and company information.
Perform other related duties as assigned.