Accounts Receivable Resolution Specialist.

Accountabilities:

As an Accounts Receivable Resolution Specialist, you will oversee complex claims resolution activities, strengthen collection processes, and support effective communication across departments. Your responsibilities will include:

• Follow up on assigned accounts daily to reduce outstanding accounts receivable and accelerate reimbursement.

• Review denied claims promptly and accurately, identifying appropriate resolution strategies, including authorization, retroactive authorization, and precertification.

• Prepare and submit appeal letters and payer-required documentation through WAYSTAR for unpaid or underpaid claims.

• Prioritize account resolution activities to improve efficiency and maximize collection outcomes.

• Document all actions and progress using standardized note formats in Avatar and WAYSTAR.

• Meet established departmental productivity and performance requirements.

• Communicate identified issues, improvement opportunities, and recommendations to leadership using the SBAR communication format.

• Follow established reporting lines and participate in departmental initiatives designed to reduce outstanding accounts receivable.

• Troubleshoot technology-related issues proactively and escalate them according to departmental guidelines.

• Assist billing teams in determining appropriate responses to incoming mail and other correspondence.

• Perform additional duties as assigned to support the department's operational objectives.

Requirements:

The ideal candidate has hands-on experience in insurance claims follow-up, denial management, and healthcare billing, along with the judgment and communication skills needed to resolve complex accounts. Required qualifications include:

• High school diploma, GED, or international equivalent.

• At least 2 years of experience in insurance claims follow-up.

• At least 2 years of experience in claims denial management.

• At least 5 years of experience working in a physician and/or healthcare facility business office.

• At least 1 year of experience working in a remote environment.

• Strong knowledge of insurance billing, claims follow-up, appeals, reimbursement processes, and denial resolution.

• Excellent analytical, organizational, and prioritization skills, with the ability to manage multiple complex accounts.

• Strong written and verbal communication skills, including the ability to work effectively with insurers, patients, providers, and internal teams.

• Good judgment, discretion, accountability, and a proactive approach to problem-solving.

• Ability to meet productivity expectations and follow established procedures and documentation standards.

• Compliance with the organization's mandatory vaccination policy, including providing proof of full vaccination or qualifying for an approved exemption before the start date.

• Compliance with seasonal flu vaccination requirements or the applicable exemption process, which may require masking during the designated flu season.

Preferred qualifications include:

• A bachelor's degree in healthcare or a related field.

• At least 5 years of experience in physician and/or facility billing or auditing within a behavioral health environment.

Benefits:

• Comprehensive healthcare coverage: Medical, dental, and vision insurance, along with accident, critical illness, and hospital indemnity coverage for employees and their families.

• Employer-paid protection: Basic life insurance, accidental death and dismemberment (AD&D), short-term disability, and long-term disability coverage.

• Voluntary life insurance: Additional coverage options for employees and their families.

• Health Savings Account (HSA): Employer contributions ranging from $1,000 to $2,000, depending on the selected plan.

• Flexible Spending Accounts (FSA): Options for healthcare and dependent care expenses.

• Retirement savings: A 401(k) plan with automatic enrollment after 90 days and an employer match after six months, matching 50% of employee contributions up to 6% of compensation.

• Paid time off: Generous PTO, starting at 160 accrued hours annually, plus 12 recognized company holidays.

• Paid parental leave: Available to eligible employees.

• Employee Assistance Program (EAP): Confidential emotional support, work-life resources, financial guidance, legal assistance, and online support.

• Remote work: Fully remote position for candidates residing in eligible states: Alabama, Arkansas, Arizona, California, Colorado, Connecticut, Washington, D.C., Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Maine, Michigan, Minnesota, Montana, North Carolina, New Jersey, New York, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington, and Wisconsin.