Senior Accounts Receivable Specialist

Ensemble Health Partners • Work at Home - Oklahoma - Other, OK

6d • $19 - $21 • Remote

About The Position

The Senior Accounts Receivable Specialist performs follow-up and denial activities to resolve claim payment issues and secure appropriate, timely reimbursement from commercial, governmental, and other payers. The role investigates denied and unpaid claims, identifies underpayments and payment delays, files technical and clinical appeals, and works with other departments to resolve issues. It also identifies denial and payment trends, monitors payer policy changes, and recommends interventions to address root causes in accounts receivable.

The specialist mentors AR team members, provides guidance on complex claims and appeals, participates in payer escalation calls, and helps leadership with accounts receivable reduction and cash acceleration projects. The role requires accurate documentation, compliance with applicable regulations and payer requirements, and achievement of established productivity, quality, and attendance standards.

This is a remote position, with willingness and ability to travel to and work onsite at client, temporary, or corporate office locations when business needs require. Pay is $18.65–$20.50 per hour, based on experience. CRCR certification, or another approved job-relevant certification, is required upon hire or within nine months of hire.

Requirements

• High school diploma, GED, or equivalent experience.
• 1 to 3 years of job experience.
• Obtain CRCR certification, or another approved job-relevant certification, upon hire or within 9 months of hire.
• Basic computer knowledge and proficiency in Microsoft Excel.
• Excellent verbal skills.
• Problem-solving skills and ability to assess accounts and determine a collection plan.
• Critical-thinking skills and ability to apply available tools to different accounts to secure payment.
• Adaptability to changing procedures and a growing environment.
• Meet quality and productivity standards within established timelines and comply with attendance policies.
• External candidates must meet quality and productivity standards by day 90; failure to do so results in demotion to AR Specialist, with eligibility to reapply for Senior AR Specialist 90 days after demotion.
• Candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.
• Candidates must reside and be authorized to work in the United States.

Nice To Haves

• A 2-year or 4-year college degree.
• At least 1 year of relevant experience in medical collections, physician or hospital operations, AR follow-up, denials and appeals, compliance, provider relations, or professional billing.
• Knowledge of claims review and analysis.
• Working knowledge of revenue cycle.
• Experience using the DDE Medicare system and payer websites to investigate claim status.
• Working knowledge of medical terminology and/or insurance claim terminology.
• Openness to innovation, including AI, to explore improved processes and reduce friction for patients and clients.

Responsibilities

• Perform follow-up and denial activities for accounts receivable.
• Contact commercial, governmental, and other payers to resolve outstanding claim payment issues and secure timely reimbursement.
• Examine denied and unpaid claims to determine the reasons for discrepancies, underpayments, denials, and payment delays.
• File technical and clinical appeals and resolve payment variances.
• Identify denial trends, payer policy changes, and root causes of accounts receivable issues; communicate findings and recommendations to management.
• Work with other departments to resolve denial issues and ensure compliant billing.
• Mentor AR Specialist team members and provide guidance on complex claims and appeals.
• Follow up on clean claim delays and record issues on escalation spreadsheets.
• Take minutes during payer escalation calls and share key takeaways with AR associates.
• Maintain an understanding of federal and state regulations and payer-specific requirements, and take appropriate action.
• Accurately document account activity and relevant contact information in the client host system or appropriate tracking system.
• Review escalations from other areas and accounts requiring escalation to other Revenue Cycle areas; assist the supervisor with DIBS calls as needed.
• Assist leadership with AR reduction and cash acceleration projects and other assigned duties.
• Meet established productivity, quality, and attendance standards.

Benefits

• Comprehensive benefits package, including healthcare, time off, retirement, and well-being programs.
• Bonus and incentive programs, including quarterly and annual incentives.
• Paid professional certifications.
• Tuition reimbursement.
• Career advancement and professional development opportunities.

What This Job Offers

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