Accounts Receivable and Denial Management Specialist
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Job Description
Remote A/R and denial specialist supporting a Florida multi-specialty physician group. Reviewing claims, resolving denials, and managing Medicare-heavy payer follow-up.
Responsibilities:
- Review pending and unbilled claim buckets in the practice management system for accuracy before submission
- Correct eligibility, wrong-payer, demographic, and coding-related errors so claims are paid on the first submission
- Verify patient eligibility and confirm the correct primary and secondary insurance
- Follow up on unpaid, underpaid, and aged claims through payer portals and phone calls
- Research denials, identify root causes, and submit corrected claims, reconsiderations, or appeals
- Check claim status and resolve issues using Medicare, Availity, and UnitedHealthcare portals
- Document all follow-up activity and next steps in the practice management system
- Report recurring denial trends and payer issues to the billing manager
- Work alongside the practice’s in-house A/R team and meet daily productivity targets
- Protect patient information and follow HIPAA requirements
- Support a multi-specialty physician group based in Florida
Requirements:
- At least 2 years of experience with U.S. healthcare A/R follow-up and denial management
- Experience reviewing claims for accuracy and resolving eligibility and payer errors
- Familiarity with commercial insurance and government health plans, including Medicare
- Experience using payer portals and insurance websites
- Strong written and spoken English
- Excellent attention to detail and follow-up skills
- Ability to work independently and manage multiple patient accounts
- Reliable internet connection and a suitable remote workspace
- Must be available during Eastern Time business hours
- Experience using AdvancedMD preferred
- Experience using First Coast SPOT (Florida Medicare), Availity, and the UnitedHealthcare provider portal preferred
- Experience supporting internal medicine, hospitalist, wound care, or pain management practices preferred
- Familiarity with Florida insurance plans preferred
- Experience working a Medicare-heavy A/R and handling Medicare reconsiderations and redeterminations preferred
Benefits:
- Full-time employment
- Remote work arrangement
- Schedule during Eastern Time business hours
- Remote workspace support implied by requirement for a suitable remote workspace
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