AR Specialist

Job Details: Job Location: Remote

• Capitol Billing Group
• Metairie, LA, Position Type: Full Time, Salary Range: Undisclosed, Job Shift: Day, Medical Accounts Receivable (A/R) Revenue Specialist Position Summary The Medical Accounts Receivable (A/R) Revenue Specialist is responsible for managing and optimizing the healthcare billing lifecycle to ensure accurate, timely reimbursement. This role serves as a key liaison between internal teams, vendor partners, insurance payers, and patients, with a strong focus on denial resolution, A/R aging follow-up, and revenue integrity. The Specialist works to maximize cash flow while ensuring compliance with payer requirements and organizational policies.

Key Responsibilities

Claims & Vendor Management Partner with external billing vendors to address claim rejections and payer requests for clarification. Provide guidance and feedback to vendor partners on claim corrections, rework, and resubmissions. Review escalated accounts requiring internal oversight or final resolution. Denial Management & Appeals Collaborate with vendor partners to identify denial trends, recurring payer issues, and root causes.

Provide feedback and strategic direction on appeal approaches and payment resolution tactics. Authorize final adjustments after all appeal opportunities have been exhausted, ensuring appropriate documentation and compliance. Recommend process improvements to reduce future denials. Accounts Receivable Follow-Up Proactively work A/R aging reports (30, 60, 90+ days) to identify unpaid or underpaid claims.

Initiate payer tracers and follow-ups to secure claim adjudication and payment. Monitor high-risk and high-dollar accounts to prevent revenue leakage. Payment Posting & Reconciliations Ensure accurate posting and reconciliation of insurance and patient payments. Transfer payments to patient balances when appropriate and process patient refunds in compliance with policy.

Assist with account reconciliations and discrepancies resolution as needed. Patient & Insurance Communication Act as a liaison between patients and insurance payers to resolve billing questions. Clearly explain Explanation of Benefits (EOBs), patient responsibility, and out-of-pocket costs. Conduct professional and empathetic phone communication with patients and payer representatives.

Qualifications

& Requirements Education High School Diploma or equivalent required Associate’s or Bachelor’s degree in Healthcare Administration, Accounting, or a related field preferred Experience 1–3 years of experience in: Medical billing and collections Accounts Receivable or Revenue Cycle Management Healthcare payer follow-up and denial resolution Technical Skills Proficiency with Practice Management Systems and Electronic Health Records (EHR/EMR) Strong working knowledge of Microsoft Office, particularly: Excel (reports, aging analysis) SharePoint Medical & Regulatory Knowledge Working knowledge of: Medical terminology CPT and ICD-10 coding Payer guidelines and reimbursement rules for Medicare, Medicaid, and Commercial Insurance plans Core Competencies Strong analytical and problem-solving skills Exceptional attention to detail and accuracy Effective written and verbal communication skills Ability to work collaboratively with internal teams and external vendor partners Sound judgment related to financial adjustments and account resolution Qualifications: