The AR Follow-Up Specialist is responsible for timely and accurate follow-up of outstanding accounts receivable within the Revenue Cycle Management (RCM) department. This role primarily supports California Medicare and Commercial AR, with additional responsibility for Workers’ Compensation and Rehab services.
The position helps ensure optimal reimbursement through proactive payer outreach, claim status monitoring, denial resolution, and coordination with billing, coding, and authorization teams. It also plays a key role in reducing days sales outstanding (DSO), improving cash flow, and supporting denial prevention strategies across all payer types.
This is a remote role. Hiring is limited to AZ, CA, NM, NV, OR, TX, and WA.
What you will do:
- Perform timely follow-up on California Medicare, Commercial, and Workers’ Compensation claims to ensure prompt adjudication
- Conduct direct outreach to commercial payers, Medicare contractors, WC adjusters, case managers, and employers to obtain claim status, authorization verification, and documentation requirements
- Resolve claim rejections, underpayments, incorrect fee schedule applications, and missing documentation across payer types
- Track and manage Workers’ Compensation payer-specific timelines, including 30-day status cycles and state-mandated payment rules
- Monitor claims for timely filing, medical necessity, eligibility discrepancies, coordination of benefits (COB), and modifier accuracy
- Coordinate with authorization teams to confirm authorization validity and ensure required documentation is submitted prior to billing
- Escalate delayed or complex cases to appropriate internal team members or external partners
- Identify opportunities for appeal when claims are underpaid or incorrectly denied for Medicare, Commercial, and WC payers
- Prepare and submit appeal letters, reconsideration requests, and supporting documentation
- Identify and report recurring denial trends and collaborate with billing, coding, and authorization teams to prevent recurrence
- Perform other duties as assigned
Qualifications
- High school diploma or GED required
- 3+ years of AR follow-up experience with strong emphasis on California Medicare and Commercial billing
- Working knowledge of Workers’ Compensation billing, including adjuster communication, state rules, medical necessity, and required documentation
- Experience managing mixed payer AR inventories with competing timelines and requirements
- Ability to work in a fast-paced environment, meet daily deadlines, and collaborate with cross-functional RCM teams
- Experience with multiple EHR / Practice Management systems such as IMS, NextGen, Athena, eClinicalWorks, or similar
- Basic understanding of NCCI edits and payer-specific billing guidelines
- Strong verbal and written communication skills with excellent attention to detail
- Advanced proficiency in Microsoft Excel, including formulas and pivot tables, plus solid Microsoft Office skills
Benefits and perks
- Amazing work/life balance
- Medical, dental, vision, and prescription benefits (PPO & HMO)
- 401(k) plan with employer matching
- License and tuition reimbursements
- Paid time off
- Holiday pay and floating holiday
- Employee perks and discount programs
- Supportive environment to help you grow and succeed
Location
California, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
1 month ago