Overview Accounts Receivable Specialist - Medical Claims Remote U.S. (designated states) This position is fully remote and may be performed from one of the following U.S. states: AL, AZ, FL, GA, IN, KS, MA, MI, MS, NC, NV, OR, PA, SC, TN, TX. At Raintree, we’re not just shaping the future of therapy technology – we’re creating it. This is your chance to be part of something bigger, where your career will have game-changing, career-defining moments that propel you to new heights. We aim to be the best place for the best people, and we’re looking for ambitious, creative thinkers ready to make an impact. Whether you’re advancing AI solutions or enhancing user experiences, your work here will shape the future of therapy technology while advancing your career alongside dedicated professionals who are as committed to your success as you are. At Raintree, your ideas drive real change, your growth is limitless, and the work you do will touch millions of lives. Ready to ignite your career and leave a lasting legacy? Join us and be part of something extraordinary. The Accounts Receivable Specialist ensures accurate, compliant, timely billing and appropriate reimbursement for multispecialty medical professional services from various insurance payers and patients. This includes correct and timely collection of unpaid patient accounts with goals to be met, re-billing, payment posting, contractual write-offs, adjustments, appeals per multi-state and federal insurance regulations for patients receiving services with our clients. Responsibilities Prepare and re-submit clean claims to various insurance companies either electronically or by paper in accordance with specific payer guidelines and/or contract requirements. Analyze and correct first pass rejected claims for completeness and accuracy of information for second pass clean claim submission. Research and perform all primary and secondary billing claim status follow up activities for assigned insurance plans. Review, evaluate and process all claim appeals through resubmission to insurance carriers with complete and accurate supporting documentation required. Research and recommend any customer account adjustments and/or write-offs to the Manager based upon collectability of account with insurance carrier or patient. Recognize and report claims problems, errors, and discrepancies to management in order to proactively identify and effectively resolve billing trends in a timely manner. Generate and submit monthly patient balance due statements to customers as dictated by the explanation of benefits received from their insurance carrier. Reviewing patient accounts, identifying delinquent accounts, and collecting overdue payments. Answering patient questions about billing and payments. Investigating and/or directing patient inquiries or complaints to the appropriate staff member. Qualifications High School Diploma, GED, or equivalent work experience. Experience in Medical Insurance Claims billing preferred. One to three (3) years of experience with a 10-Key by touch. Proficient in Microsoft office (Outlook, Excel, Word) and Google applications. Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to define problems, collect data, establish facts, and identify trends. Ability to exercise good judgment and escalate issues appropriately. Competencies to Drive Success Strong written and verbal communication skills; a self-starter who is dependable and reliable. Must work well within a team structure, possessing outstanding interpersonal relationship skills, as well as the ability to work independently. Strong organizational skills and detail oriented with the ability to prioritize, complete tasks, and meet deadlines. Must be able to promote a positive influence within the team, department, and company. Ensure and adhere to departmental compliance with HIPAA guidelines, Raintree Systems, Inc. HR policies, standard operating procedures, and other corporate initiatives. Perks Remote Work/Work From Home Paid Time Off/11 Paid Holidays/Year-End Holiday Break Health, Dental, Vision, HSA/FSA 401K with Company Match Disability & Life Insurance Employee Assistance Program Paid Parental Leave #J-18808-Ljbffr
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