Accounts Receivable Specialist

Job Description

Job Description

ExperCARE Health is seeking an Accounts Receivable Specialist to support our Revenue Cycle Management team. This role is responsible for managing insurance accounts receivable, ensuring claims are processed accurately, and following up on outstanding balances with insurance carriers.

The ideal candidate will have experience in healthcare revenue cycle processes, strong analytical skills, and the ability to communicate effectively with internal teams and insurance representatives to resolve claim and payment issues.

Responsibilities

• Manage assigned insurance accounts receivable and review aging reports to ensure timely payment of claims
• Follow up with insurance carriers regarding outstanding claims, underpayments, and payment discrepancies
• Identify and resolve claim denials and payment trends
• Process secondary insurance claims accurately and in a timely manner
• Audit patient ledgers to ensure correct charge posting, payments, contractual adjustments, and account balances
• Research missing or delayed payments and gather documentation needed for claim resolution
• Work denied or rejected claims and resubmit claims for appropriate reimbursement
• Prepare and submit claim appeals according to payer guidelines and filing deadlines
• Review clinical documentation when needed to support appeal submissions
• Ensure adjustments and write-offs follow company policies and are properly documented
• Maintain clear communication with clinic teams, Revenue Cycle staff, and insurance representatives
• Assist with additional Revenue Cycle projects and responsibilities as assigned

Qualifications

• 2+ years of experience in healthcare Revenue Cycle or Accounts Receivable
• Experience reviewing Explanation of Benefits (EOBs) and communicating with insurance representatives
• Knowledge of medical insurance processes and medical terminology
• Strong analytical, critical thinking, and problem-solving skills
• Proficiency in Microsoft Office Suite, including Excel, Word, and Outlook
• Strong attention to detail and organizational skills
• Ability to work independently and in a team-oriented environment
• High School Diploma or equivalent required

ExperCARE Health is committed to providing exceptional care to our patients and fostering a supportive, collaborative environment for our team members.