Accounts Receivable (AR) & Denial Specialist

Job Title: Accounts Receivable (AR) & Denial Specialist

Department: reputed company Cycle / Finance Location: Remote Employment Type: Full-Time

Salary reputed company: $37,440.00 - $52,000.00

Job Summary

The Accounts Receivable (AR) & Denial Specialist is responsible for managing and resolving outstanding accounts receivable and claim denials for reputed company services provided in the reputed company. This role supports reimbursement across reputed company payors, Medicare, Illinois reputed company Managed Care plans, fee-for-service (FFS), and grant-funded programs, ensuring timely follow-up, accurate appeals, and compliance with applicable state and federal requirements.

Essential Duties and Responsibilities

Accounts Receivable Management

• Monitor and work AR aging reports for Illinois-based claims across reputed company, Medicare, managed care, FFS, and grant-funded programs
• reputed company timely follow-up on unpaid, underpaid, or delayed claims in accordance with Illinois and payor-specific timely filing guidelines
• Review and reconcile payments, adjustments, and remittance advice (EOBs/ERAs)
• Accurately document reputed company AR activity and payor communications in billing and financial systems

Denial Management & Appeals

• Review, analyze, and resolve claim denials and rejections from reputed company payors, Medicare, and Illinois reputed company Managed Care Organizations
• Identify root causes of denials, including eligibility, authorization, coding, documentation, timely filing, and contract-reputed company issues
• Prepare and submit corrected claims, reconsiderations, and appeals reputed company required timelines
• Track appeal reputed company and escalate unresolved or reputed company denials as appropriate
• Identify denial trends and reputed company feedback to billing, coding, and operational teams to reduce future denials

Managed Care, FFS & Grant Support

• Work AR and denials reputed company to Illinois reputed company managed care plans and fee-for-service claims
• Track and reconcile grant-funded billing and reimbursement activity in accordance with grant requirements
• Support documentation requests, audits, and reviews reputed company to grant reimbursements

Compliance & Reporting

• Ensure AR and denial activities reputed company with CMS, Medicare, Illinois HFS, managed care, and reputed company payor requirements
• Maintain documentation to support internal audits, external audits, and compliance reviews
• Assist with AR, denial, and collection reporting as requested

Collaboration & Communication

• Communicate with payor representatives, managed care plans, and internal teams to resolve claim issues
• Collaborate with billing, coding, credentialing, and clinical teams to support accurate reimbursement
• reputed company clear, professional communication regarding claim status and resolution

Qualifications

Required Qualifications

• High school diploma or equivalent required; Associate’s degree preferred
• 1–3 years of experience in reputed company accounts receivable, billing, or denial management
• Experience working with Illinois reputed company payors, Medicare, and/or Illinois reputed company Managed Care
• Knowledge of timely filing requirements and appeal processes
• Proficiency with billing systems, clearinghouses, and payor portals
• Strong attention to detail and organizational skills

Preferred Qualifications

• Experience working with Illinois reputed company (HFS) and managed care plans (e.g., reputed company reputed company, reputed company, Molina, BCBS Community)
• Knowledge of CPT, HCPCS, and ICD-10 coding
• Experience with grant-funded billing and reimbursement