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We are a growing Arthritis and Rheumatology Center located in North Georgia, seeking a detail-oriented and experienced Accounts Receivable (A/R) Specialist to join our team in Cumming office. The ideal candidate will have a strong understanding of medical insurance processes, payer policies, and reimbursement procedures. This position is responsible for reviewing and resolving outstanding insurance balances, interpreting Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs), and working closely with insurance payers to ensure timely and accurate payments.
Key Responsibilities:Maintain full ownership of assigned A/R aging report, prioritizing accounts based on payer deadlines and dollar value
Aggressively follow up on unpaid, underpaid, and denied claims to ensure timely reimbursement
Analyze aging balances and take immediate corrective action to prevent accounts from exceeding payer timely filing limits
Research claim issues and resolve them in accordance with individual payer regulations, contracts, and billing guidelines
Identify root causes of denials and payment delays and implement corrective actions
Submit corrected claims, appeals, and reconsiderations within payer-specific timeframes
Review EOBs and remittance advice to ensure payments align with contracted rates
Escalate unresolved or systemic payer issues with clear documentation and recommendations
Communicate professionally and effectively with insurance carriers to resolve discrepancies
Collaborate with billing, coding, and front-office staff to reduce recurring claim errors
Maintain strict compliance with HIPAA, payer rules, and practice policies
Prepare and review A/R and aging reports and provide regular status updates to management
2+ years of experience in medical billing, A/R follow-up, or insurance claims resolution.
Strong understanding of insurance processes (commercial plans, Medicare, BCBS, United Healthcare, etc).
Proficient in reading EOBs, ERAs, and payer remittance summaries.
Experience working payer A/R and resolving outstanding claims.
Excellent verbal and written communication skills for interacting with payers and internal teams.
Ability to work independently, manage time effectively, and prioritize tasks.
Familiarity with billing software and eClinicalworks is a must!
Experience with high-volume A/R follow-up.
Knowledge of CPT, ICD-10, and HCPCS coding.
Previous experience working with specific payers (e.g., Aetna, UnitedHealthcare, Blue Cross Blue Shield, Medicare).
Demonstrate consistent compliance with payer regulations and deadlines
Identify trends and recommend process improvements to prevent revenue loss
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