AR Specialist
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Job Description
AR Specialist managing Medicare, Commercial, and Workers’ Compensation claims for Boomerang Healthcare’s multidisciplinary pain-care services. Resolving denials and improving reimbursement through revenue cycle follow-up.
Responsibilities:
- Perform timely follow-up on California Medicare, Commercial, and Workers’ Compensation claims to ensure prompt adjudication
- Conduct direct outreach to commercial payers, Medicare contractors, WC adjusters, case managers, and employers to obtain claim status, authorization verification, and documentation requirements
- Resolve claim rejections, underpayments, incorrect fee schedule applications, and missing documentation across payer types
- Track and manage Workers’ Compensation payer-specific timelines, including 30-day status cycles and state-mandated payment rules
- Monitor claims for timely filing, medical necessity, eligibility discrepancies, coordination of benefits, and modifier accuracy
- Coordinate with authorization teams to confirm authorization validity and ensure required documentation is submitted prior to billing
- Escalate delayed or complex cases to appropriate internal team members or external partners
- Identify opportunities for appeal when claims are underpaid or incorrectly denied
- Prepare and submit appeal letters, reconsideration requests, and supporting documentation
- Identify and report recurring denial trends and collaborate with billing, coding, and authorization teams to prevent recurrence
- Assume other responsibilities as appropriate to the position and organizational needs
- Support Boomerang Healthcare’s revenue cycle management operations for multidisciplinary pain-care services
Requirements:
- High school diploma or GED required
- 3+ years of AR follow-up experience with strong emphasis on California Medicare and Commercial billing
- Working knowledge of Workers’ Compensation billing, including adjuster communication, state rules, medical necessity, and required documentation
- Experience managing mixed payer AR inventories with competing timelines and requirements
- Ability to work in a fast-paced environment, meet daily deadlines, and collaborate with cross-functional RCM teams
- Experience with multiple EHR / Practice Management systems (IMS, NextGen, Athena, eClinicalWorks, or similar)
- Basic understanding of NCCI edits and payer-specific billing guidelines
- Strong verbal and written communication skills; excellent attention to detail
- Advanced proficiency in Microsoft Excel (formulas, pivot tables) and solid skills in other Microsoft Office applications
- Must be available Monday-Friday, 8am-5pm
- Must work 40 hours per week
Benefits:
- Amazing work/life balance
- Generous Medical, Dental, Vision, and Prescription benefits (PPO & HMO)
- 401(K) Plan with Employer Matching
- License & Tuition Reimbursements
- Paid Time Off
- Holiday Pay & Floating Holiday
- Employee Perks and Discount Programs
- Supportive environment to help you grow and succeed
- Remote work arrangement
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