The Accounts Receivable / Revenue Cycle Specialist is responsible for managing receivables throughout the revenue cycle, with a strong focus on claims follow-up, denial resolution, and timely reimbursement. This role works closely with billing, coding, and clinical teams to ensure accurate claim submission and effective resolution of payer issues. The ideal candidate has hands-on experience in healthcare revenue cycle operations and is proficient in EHR systems such as eClinicalWorks and Athena.

Key Responsibilities

• Manage accounts receivable activities across the revenue cycle, including claims follow-up, payment posting review, and account resolution
• Research and resolve unpaid, underpaid, and denied claims with commercial, Medicare, and Medicaid payers
• Work within EHR and practice management systems (including eClinicalWorks, Athena, or similar platforms) to review claims, patient accounts, and documentation
• Identify root causes of denials and payment delays and communicate trends to billing, coding, and leadership teams
• Ensure compliance with payer requirements, contracts, and healthcare regulations
• Maintain accurate documentation of account activity and follow-up actions within the system
• Collaborate with internal teams to resolve eligibility, authorization, coding, and charge-related issues impacting reimbursement
• Monitor aging reports and prioritize high-dollar or high-risk accounts to support cash flow goals
• Respond to payer and internal inquiries in a timely and professional manner
• Support month-end reporting and revenue cycle performance initiatives as needed

Qualifications

• High school diploma or equivalent required; associate or bachelor's degree preferred
• 3-5 years of accounts receivable experience within a healthcare or medical billing environment
• Strong understanding of healthcare revenue cycle processes, including insurance follow-up and denial management
• Hands-on experience with EHR and practice management systems, specifically eClinicalWorks, Athena, or similar platforms
• Working knowledge of CPT, ICD-10, and insurance reimbursement methodologies
• Experience working with commercial payers, Medicare, and Medicaid
• Strong analytical, organizational, and problem-solving skills
• Ability to manage multiple priorities and meet productivity and follow-up targets
• Strong written and verbal communication skills