Accounts Receivable Specialist
Quick Med Claims, LLC
Insurance Accounts Receivable Specialist III
Solaris Health
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Perform billing-related tasks including data entry, claim review, charge review, and accounts receivable follow-up.
- Resolve high-complexity insurance accounts including denials related to medical necessity, non-covered services, bundling, and out-of-network claims (OON).
- Manage higher volume and complexity of work compared to Levels I and II while meeting productivity standards.
- Complete daily tasks in assigned work queues according to established workflows and manager direction.
- Utilize CBO Pathways, payer websites, billing systems, and training materials to resolve unpaid or incorrectly paid claims and authorize procedures.
- Identify and escalate payer issues, credentialing discrepancies, or coding concerns to management.
- Review reports to identify revenue opportunities and outstanding claims requiring follow-up.
- Adhere to departmental workflows, regulatory requirements, FGP compliance, and patient confidentiality guidelines (HIPAA).
- Communicate with patients, providers, coders, and other stakeholders to ensure accurate and timely claims processing.
- Provide insight and feedback on system edits, billing processes, and procedural improvements.
- Make corrections to system records to meet payer requirements and resubmit claims.
- Train and mentor new hires and provide guidance to team members as needed.
- Review and write appeals and assist staff in resolving complex claim or appeal-related questions.
- Perform other position-related duties and comply with Solaris Health Code of Conduct and annual compliance training.
Requirements
- High school diploma or equivalent required.
- Associates degree in related field preferred.
- Previous experience in a customer service or healthcare setting required.
- Advanced knowledge of billing systems, denial management, and payer-specific requirements.
- Experience writing appeals and handling escalated claim issues.
- Ability to coach, train, and mentor other team members.
- Strong analytical and decision-making skills; able to handle complex accounts independently.
- Skill in using computer programs and applications including Microsoft Office.
- Maintain the confidentiality of patients' protected health information in compliance with HIPAA.
- Ability to identify trends, propose solutions, and contribute to process improvements.
Benefits
- Competitive pay
- PTO
- Holiday pay
- Comprehensive benefits package
- Health insurance
- Dental insurance
- Vision insurance
- Life Insurance
- Pet Insurance
- Health savings account
- Paid sick time
- Paid time off
- Paid holidays
- Profit sharing
- Retirement plan
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
billing systemsdenial managementclaims processingdata entrycharge reviewaccounts receivablewriting appealsanalytical skillsdecision-making skillsprocess improvements
Soft skills
coachingtrainingmentoringcommunicationproblem-solvingindependent workattention to detailtime managementteam collaborationcustomer service
