Position Type: Full-Time
Onsite – Wausau, WI
About the Role
We are seeking an organized, detail-oriented Accounts Receivable Specialist to join a healthcare Patient Accounts team. This position focuses on following up on outstanding insurance and patient balances, resolving denied or delayed claims, and helping ensure accurate and timely reimbursement for medical services.
The ideal candidate has experience in medical billing, insurance follow-up, or healthcare revenue cycle operations and enjoys investigating discrepancies, solving problems, and working collaboratively with others to resolve accounts.
What You’ll Do
- Manage assigned accounts receivable for physician, advanced practice provider, ambulatory surgery center, physical therapy, and ancillary services.
- Follow up with insurance carriers, patients, employers, and other responsible parties regarding unpaid, underpaid, denied, rejected, or delayed claims.
- Review Explanation of Benefits (EOBs), Electronic Remittance Advice (ERAs), and payer correspondence to verify payment accuracy and identify discrepancies.
- Submit corrected claims, reconsiderations, and appeals within established payer deadlines.
- Research and resolve billing issues involving coding, eligibility, authorizations, coordination of benefits, medical necessity, and reimbursement requirements.
- Process insurance and patient payments, contractual adjustments, refunds, and credit balances accurately.
- Maintain clear and accurate account documentation in electronic health records and practice management systems.
- Collaborate with billing, coding, registration, scheduling, clinical, and patient financial services teams to resolve account issues.
- Respond professionally to billing inquiries from patients, insurance companies, employers, attorneys, and other stakeholders.
- Monitor aging accounts, identify denial and payment trends, and contribute to process improvements.
- Follow HIPAA requirements, payer guidelines, and organizational policies.
- Assist with other revenue cycle functions, including charge entry and payment posting, as needed.
What We’re Looking For
- High school diploma or equivalent.
- At least 2 years of medical accounts receivable, insurance follow-up, medical billing, or healthcare revenue cycle experience.
- Knowledge of medical insurance reimbursement, claims processing, denial management, appeals, and payer filing deadlines.
- Experience working with multiple payer types, including Medicare, Medicaid, commercial insurance, Workers’ Compensation, Veterans Affairs (VA), and self-pay accounts.
- Familiarity with EOBs, ERAs, payment variances, coordination of benefits, and prior authorization requirements.
- Working knowledge of medical terminology and medical billing code sets, including CPT, HCPCS, ICD-10-CM, and modifiers. Coding certification is not required.
- Experience using electronic health records (EHRs), practice management systems, payer portals, and clearinghouses.
- Strong attention to detail, analytical thinking, and problem-solving skills.
- Excellent communication and customer service skills.
- Ability to manage competing priorities, work independently, and meet productivity and quality expectations.
Preferred Qualifications
- Experience in a physician practice, ambulatory surgery center, or multispecialty medical practice.
- Experience with both professional and facility medical billing.
- Associate degree in Business, Healthcare Administration, Health Information Management, or a related field.
- Revenue cycle certification, such as Certified Revenue Cycle Representative (CRCR), Certified Professional Biller (CPB), or a similar credential.
Why This Opportunity?
This role offers the opportunity to use your medical billing and insurance follow-up experience in a collaborative healthcare environment. You’ll play an important part in resolving outstanding accounts, supporting accurate reimbursement, and helping improve revenue cycle processes.
If you have a background in medical billing, accounts receivable, insurance follow-up, or denial management, we’d love to hear from you!