Patient Account Specialist

Patient Account Specialist Sr.

We are seeking an experienced Patient Account Specialist Sr. with a strong background in medical insurance collections and denial resolution. This role is responsible for managing accounts receivable, resolving denied or underpaid claims, and ensuring accurate and timely reimbursement from insurance payers.
This is a fully onsite position supporting a high-volume healthcare collections environment. Candidates must be comfortable working directly with payers, patients, and third-party vendors while maintaining compliance with all regulatory guidelines.
Key Responsibilities

Manage and collect outstanding balances from commercial and government insurance payers
Investigate and resolve denied and underpaid claims within payer guidelines
Perform detailed follow-up and account resolution activities for assigned AR inventory
Utilize knowledge of payer processes, appeals, and reimbursement methodologies
Interpret Explanation of Benefits (EOBs) and ensure proper billing and filing compliance
Work within payer portals and systems to track and resolve claims
Identify trends impacting reimbursement and escalate issues as needed
Communicate effectively with patients, clients, and external vendors
Maintain compliance with all state, federal, and client-specific regulations
Qualifications

Minimum 2+ years of experience in medical collections or healthcare revenue cycle
Proven experience with insurance claims denials and appeals
Strong understanding of:

AR follow-up (active AR & bad debt)
Insurance billing and reimbursement processes
Government and commercial payer guidelines

Familiarity with Explanation of Benefits, billing forms, and payer portals
Strong communication and problem-solving skills
Ability to work in a fast-paced, high-volume environment
Additional Notes

Medical clearance required prior to start