Description
Job Position: Medical AR Recovery & Denials Specialist |
About the Role
We’re hiring a Medical AR Recovery & Denials Specialist to help us recover revenue, reduce aged AR, and stop preventable denials before they happen.
If you live for clearing 90+/120+ day buckets, love cracking payer rules, and can prove your impact with real numbers, we want you on the team.
- Own aging reports and drive action on 90+ and 120+ day accounts
- Investigate denials, prepare/submit appeals, and overturn them with payers
- Track recovery metrics: % reduction in DSO, $ recovered, denial overturn rate
- Identify root causes and partner with billing to prevent repeat issues
Billing Software & Revenue Technology
- Work in major EHR/EMR platforms for follow-up, documentation, and posting
- Use clearinghouses: Availity, Waystar, ClaimMD for claim status, ERA, and submissions
- Navigate payer portals for eligibility, status, and appeal requirements
- Build reports and dashboards in Excel using VLOOKUPs and pivot tables
Payer Knowledge & Compliance
- Apply deep knowledge of Medicare, Medicaid, and commercial payer guidelines
- Ensure appeals meet timely filing and payer-specific requirements
- Support prior authorization follow-ups and flag PA-related denial trends
Medical Coding Literacy
- Read and interpret ICD-10-CM, CPT, and HCPCS codes
- Spot coding/modifier errors causing denials — e.g. Modifier 25, NCCI edits
- Collaborate with coding team on education. Certified coder not required — code literacy is key
Recovery Work & Professionalism
- Bring previous dedicated experience in medical AR recovery
- Maintain stable work history and professional communication with payers + internal teams
- Document everything clearly for audits and handoffs
Shift Time: 5.30 TO 2.30 AM ( +/- 1hrs)RequirementsRequirements:
3+ years in medical AR recovery/denials. RCM, hospital, or physician practice experience preferred
- Proven metrics: reduced DSO, recovered $ amounts, increased appeal success rate
- Hands-on with EHR/EMR + Availity, Waystar, ClaimMD + payer portals
- Advanced Excel: VLOOKUPs, pivot tables, data analysis for reporting
- Strong grasp of Medicare, Medicaid, and commercial payer rules
- Code-literate in ICD-10-CM, CPT, HCPCS. Ability to identify denial-driving errors
- Detail-oriented, persistent, and excellent at professional written/verbal communication
