Medical Accounts Receivable Specialist 2

• Independently manage assigned accounts receivable inventory, including aged claims spanning 31–120+ days.
• Investigate and resolve standard to moderately complex claim rejections, denials, underpayments, and outstanding balances.
• Prepare and submit appeals, corrected claims, and supporting documentation within payer filing deadlines.
• Directly engage insurance payers through calls, portals, and written correspondence to resolve claim issues and secure appropriate reimbursement.
• Apply judgment when prioritizing accounts and determining appropriate follow-up and resolution pathways.
• Review claim history, payer responses, account documentation, and payment information to determine next steps.
• Maintain accurate, thorough documentation of account activity, payer communications, and follow-up plans.
• Identify recurring denial patterns and payer trends; escalate systemic issues and complex cases to a Level 3 AR Specialist or management.
• Address routine to moderately complex patient account questions and escalate sensitive or unresolved concerns as needed.
• Process account adjustments and write-off requests in accordance with company policies and assigned approval authority.
• Collaborate with billing, coding, credentialing, and clinic teams to obtain information needed for claim resolution.
• Meet established productivity, quality, and follow-up expectations while operating with moderate oversight.
• Assist with Level 1 Accounts Receivable responsibilities across financial classes as business needs require.

• Strong working knowledge of medical billing, insurance follow-up, denial management, and appeals processes.
• Ability to independently investigate and resolve standard to moderately complex reimbursement issues.
• Understanding of payer requirements, timely filing limits, explanation of benefits (EOBs), electronic remittance advice (ERAs), and common denial codes.
• Ability to apply payer policies and basic coding and reimbursement concepts to claim resolution.
• Sound judgment in prioritizing aged inventory, selecting resolution pathways, and recognizing when escalation is needed.
• Ability to recognize recurring payer issues and clearly communicate trends with supporting examples.
• Excellent written and verbal communication skills.
• Strong attention to detail and ability to manage multiple workflows and deadlines.
• Ability to maintain effective working relationships with patients, payers, medical staff, and internal teams.
• Ability to remain calm and professional during challenging payer or patient conversations.

Supervisory Responsibilities