NextCare is looking for an Accounts Receivable Specialist to play a key role in maintaining our organization's financial health. You will focus on the timely and accurate resolution of outstanding medical claims, requiring a deep understanding of the medical billing lifecycle and payer guidelines.
What You'll Do
- Verify patient insurance eligibility and benefits before claim submission.
- Review and analyze clearinghouse rejections to identify root causes for rejected claims.
- Monitor and follow up on unpaid and denied medical claims across a variety of payers to ensure timely reimbursement.
- Research, analyze, and resolve claim denials and underpayments by identifying root causes, correcting errors, submitting appeals, or providing additional documentation.
- Reconcile accounts receivable by posting adjustments and resolving discrepancies to maintain accurate financial records.
- Generate and analyze A/R reports to identify patterns in denials or delays and recommend process improvements.
- Partner with billing, coding, and compliance teams to ensure claims are processed accurately and efficiently.
- Maintain strict adherence to HIPAA regulations, payer-specific guidelines, and company policies.
- Treat patients and co-workers consistent with the NextCare Mission Statement, Vision, Values and Performance Standards.
- Perform other related duties as assigned or described in Company policy.
What We're Looking For
- Minimum of a High School diploma or equivalent.
- Minimum of 5 years of experience in medical billing or accounts receivable with a strong emphasis on insurance claim resolution and denial management.
- In-depth understanding of medical billing and coding principles and payer reimbursement methodologies.
- Waystar Clearinghouse expertise.
- Strong ability to interpret EOBs, remittance advice, and payer correspondence to resolve complex claim issues.
- Exceptional accuracy in data entry, financial reconciliation, and documentation.
- Effective written and verbal communication skills to interact professionally with payers, internal teams, and external stakeholders.
Nice to Have
- Experience with NextGen Billing.
Technical Stack
- Medical billing software
- NextGen Billing
- Waystar Clearinghouse
NextCare is an equal opportunity employer.
