Required Skills & Experience
- Minimum of 2 years of healthcare Accounts Receivable experience.
- Strong experience working insurance denials, appeals, and claim follow-up.
- Experience contacting insurance companies to resolve reimbursement issues.
- Knowledge of payer portals and insurance claims processing.
- Ability to analyze EOBs, remittance advice, and claim denials.
- Strong attention to detail and problem-solving skills.
- Excellent communication and documentation skills.
- Comfortable working independently in a remote environment.
Nice to Have Skills & Experience
- Infusion billing or infusion AR experience.
- Gastroenterology (GI) revenue cycle experience.
- Experience with: ○ eClinicalWorks (eCW) ○ Waystar ○ ZirMed
- Knowledge of authorization review and infusion-specific reimbursement workflows.
- Experience handling complex, high-dollar claims requiring extensive payer follow-up.
Job Description
We are seeking an experienced Infusion Accounts Receivable (AR) Specialist to join a growing Revenue Cycle team supporting infusion services across a large multi-state healthcare organization. This individual will focus on complex AR follow-up, denial resolution, appeals, and payer communication for infusion-related claims. This is not a data-entry position. The ideal candidate will have a strong background in healthcare accounts receivable, insurance follow-up, and appeals management, with the ability to investigate claim issues, analyze authorizations, and work directly with insurance payers to secure appropriate reimbursement.
Key Responsibilities
- Manage and resolve assigned infusion-related AR accounts and insurance denials.
- Investigate denied, underpaid, and unpaid claims to determine root cause and next steps.
- Review authorizations and documentation to identify payer-related issues versus operational or authorization deficiencies.
- Prepare and submit appeals and supporting documentation to insurance carriers.
- Contact commercial, Medicare, and Medicaid payers regarding outstanding claims and reimbursement issues.
- Navigate payer portals and billing systems to obtain claim status updates and resolve payment delays.
- Maintain detailed account documentation and follow-up notes.
- Work collaboratively with leadership and revenue cycle teams to reduce aging AR balances.
- Meet productivity and quality standards while ensuring accurate claim resolution. Escalate trends, payer issues, and reimbursement concerns when appropriate.