Medical Accounts Receivable Specialist 3
About the job
- The specialist must investigate complex data sets, perform root cause analysis on denial trends, and independently solve ambiguous billing or reimbursement problems.
- The specialist must have expert-level knowledge of insurance workflows, advanced appeal strategies, coding rules, and diverse payer reimbursement logic.
- The specialist must navigate high-dollar disputes and implement advanced resolution pathways under minimal supervision.
- The specialist must clearly explain complex policy concepts and serve as a technical resource and mentor to junior staff.
- The specialist must have excellent written and verbal communication skills.
- The specialist must prioritize and manage multiple workflows and deadlines.
- The specialist must maintain effective working relationships with patients, medical staff, and the public.
- The specialist must react calmly and effectively in difficult or emergent situations, including de-escalating sensitive patient concerns.
- Resolve highly complex and high-dollar reimbursement issues.
- Perform root cause analysis on denial trends and payer behavior.
- Manage systemic payer issues affecting multiple claims or locations.
- Serve as the escalation point for Level 1 and Level 2 Accounts Receivable Specialists, including resolving the most complex patient account and payer concerns.
- Handle sensitive and complex patient interactions, providing advanced problem-solving and de-escalation for challenging account issues.
- Develop advanced appeal strategies and resolution pathways.
- Interpret complex payer policies, coding rules, and reimbursement logic.
- Identify breakdowns in payer processes and recommend corrective action.
- Support process improvement initiatives across the revenue cycle.
- Provide guidance on complex claim scenarios and payer disputes.
- Review and approve account write-offs and adjustments up to $1,000, and escalate amounts exceeding this threshold for management approval.
- Assist with standard Level 1 and Level 2 Accounts Receivable responsibilities across all financial classes as business needs require.
- Monitor, guide, and review the work of Level 1 and Level 2 Accounts Receivable Specialists on escalated, high-dollar cases to ensure accurate resolution.
- Conduct one-on-one meetings with department and cross-departmental teams to share denial trends.
About the company
Aspire Allergy & Sinus runs a network of clinics that diagnose and treat allergies, sinus conditions, and asthma across patients of all ages. Its services include comprehensive allergy testing, personalized treatment plans, and in-office sinus procedures, providing a one-stop pathway from testing to treatment. The company delivers direct patient care through its clinics, focusing on specialty healthcare to streamline the patient experience and improve outcomes in the regions it serves. Unlike general practitioners or solo practices, Aspire Allergy & Sinus combines testing, clinical care, and procedural services under one specialty network to offer coordinated allergy and sinus care.
Company Size
51-200
Company Stage
N/A
Total Funding
N/A
Headquarters
Austin, Texas
Founded
2012
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Simplify's Take
What believers are saying
- Georgetown opened April 9, 2026, making eight Aspire locations in Greater Austin.
- Aspire added Adair Allergy & Asthma in 2026, expanding Dallas-Fort Worth density.
- The company markets 58-allergen testing and in-house compounded treatments, supporting premium pricing.
What critics are saying
- BBB logged 18 complaints through 2026, driven by billing disputes and unreachable support.
- Reviews cite surprise nasal endoscopy charges and delayed communication, hurting retention and referrals.
- Source Capital-backed rollup growth depends on integrations; a failed DFW expansion dents the platform.
What makes Aspire Allergy & Sinus unique
- Aspire Allergy & Sinus operates 60-plus clinics across Texas, Arizona, Colorado, Florida, and New Mexico.
- It bundles allergy testing, allergy drops, allergy shots, and minimally invasive sinus procedures.
- The 2026 Adair acquisition added board-certified allergists and nine staff in Coppell.
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Benefits
Remote Work Options