Accounts Receivable Specialist (Healthcare)

TL;DR

Accounts Receivable Specialist (Healthcare): Managing follow-ups, tracking, and resolution of unpaid insurance claims for multiple provider entities with an accent on reducing days in AR and resolving claim denials. Focus on navigating payer portals, investigating root causes of rejections, and ensuring timely reimbursement from Medicare and commercial payers.

Location: Remote (Philippines). Must be able to work US business hours.

Company

hirify.global is a service provider specializing in operational support for healthcare entities.

What you will do

• Perform daily follow-up on outstanding insurance claims via payer portals and phone lines.
• Monitor aging AR reports and prioritize claims based on age, value, and timely-filing deadlines.
• Investigate root causes of claim denials (e.g., coding errors, POS, COB) and coordinate corrections.
• Document all payer communications and subsequent actions within the billing/claims system.
• Escalate claims requiring medical records or appeals and track submission deadlines.
• Identify recurring denial trends and support coordination of benefits (COB) and secondary claim submissions.

Requirements

• 2+ years of experience in healthcare accounts receivable, medical billing, or claims follow-up.
• Working knowledge of Medicare Part B, Medicaid, and commercial payer claim requirements.
• Familiarity with common payer portals (e.g., Availity, NGSConnex, Novitasphere, Payspan).
• Understanding of CPT, ICD-10, and POS coding as it relates to denials.
• Ability to work US business hours.
• Strict compliance with HIPAA and PHI handling requirements.

Nice to have

• Experience with telehealth, RPM/RTM, or preventive medicine billing models.
• Experience with denial management, prepayment reviews, or payer audits.
• Experience supporting credentialing or payer enrollment processes.