Accounts Receivable (A/R) and Denial Management Specialist

This is a remote position.

Job Summary RCM Staff BPO is hiring a full-time Accounts Receivable (A/R) and Denial Management Specialist to support a multi-specialty physician group based in Florida. You will review claims for accuracy before submission, work aged A/R, and resolve denials so the practice gets paid faster and with fewer rejections. This role requires strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans, especially Medicare. Key Responsibilities

- Review pending and unbilled claim buckets in the practice management system for accuracy before submission

- Correct eligibility, wrong-payer, demographic, and coding-related errors so claims are paid on the first submission

- Verify patient eligibility and confirm the correct primary and secondary insurance

- Follow up on unpaid, underpaid, and aged claims through payer portals and phone calls

- Research denials, identify the root cause, and submit corrected claims, reconsiderations, or appeals

- Check claim status and resolve issues using Medicare, Availity, and UnitedHealthcare portals

- Document all follow-up activity and next steps clearly in the practice management system

- Report recurring denial trends and payer issues to the billing manager

- Work alongside the practice’s in-house A/R team and meet daily productivity targets

- Protect patient information and follow HIPAA requirements

Qualifications

- At least 2 years of experience with U.S. healthcare A/R follow-up and denial management

- Experience reviewing claims for accuracy and resolving eligibility and payer errors

- Familiarity with commercial insurance and government health plans, including Medicare

- Experience using payer portals and insurance websites

- Strong written and spoken English

- Excellent attention to detail and follow-up skills

- Ability to work independently and manage multiple patient accounts

- Reliable internet connection and a suitable remote workspace

Preferred Qualifications

- Experience using AdvancedMD

- Experience using First Coast SPOT (Florida Medicare), Availity, and the UnitedHealthcare provider portal

- Experience supporting internal medicine, hospitalist, wound care, or pain management practices

- Familiarity with Florida insurance plans

- Experience working a Medicare-heavy A/R and handling Medicare reconsiderations and redeterminations

Schedule

- Full-time position

- Must be available during Eastern Time business hours

- Final schedule will be determined based on practice needs

Work Arrangement

- Remote

- Philippines-based applicants preferred

Originally posted on Himalayas