Accounts Receivable (A/R) and Denial Management Specialist

RCM Staff LLC · via Himalayas ·

TypeFull-time job
LocationUnited States
Posted1 hour ago
This is a remote position.

Job SummaryRCM Staff BPO is hiring a full-time Accounts Receivable (A/R) and Denial Management Specialist to support a multi-specialty physician group based in Florida.You will review claims for accuracy before submission, work aged A/R, and resolve denials so the practice gets paid faster and with fewer rejections. This role requires strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans, especially Medicare.Key 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 the root cause, 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 clearly 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

Qualifications

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

Preferred Qualifications

Experience using AdvancedMD

Experience using First Coast SPOT (Florida Medicare), Availity, and the UnitedHealthcare provider portal

Experience supporting internal medicine, hospitalist, wound care, or pain management practices

Familiarity with Florida insurance plans

Experience working a Medicare-heavy A/R and handling Medicare reconsiderations and redeterminations

Schedule

Full-time position

Must be available during Eastern Time business hours

Final schedule will be determined based on practice needs

Work Arrangement

Remote

Philippines-based applicants preferred

Originally posted on Himalayas
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