Accounts Receivable (A/R) and Denial Management Specialist

This is a remote position. Job Summary RCM Staff BPO is hiring a full-time Accounts Receivable (A/R) and Denial Management Specialist to support a multi-specialty physician group based in Florida. You will review claims for accuracy before submission, work aged A/R, and resolve denials so the practice gets paid faster and with fewer rejections. This role requires strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans, especially Medicare. Key Responsibilities - Review pending and unbilled claim buckets in the practice management system for accuracy before submission - Correct eligibility, wrong-payer, demographic, and coding-related errors so claims are paid on the first submission - Verify patient eligibility and confirm the correct primary and secondary insurance - Follow up on unpaid, underpaid, and aged claims through payer portals and phone calls - Research denials, identify the root cause, and submit corrected claims, reconsiderations, or appeals - Check claim status and resolve issues using Medicare, Availity, and UnitedHealthcare portals - Document all follow-up activity and next steps clearly in the practice management system - Report recurring denial trends and payer issues to the billing manager - Work alongside the practice’s in-house A/R team and meet daily productivity targets - Protect patient information and follow HIPAA requirements Qualifications - At least 2 years of experience with U.S. healthcare A/R follow-up and denial management - Experience reviewing claims for accuracy and resolving eligibility and payer errors - Familiarity with commercial insurance and government health plans, including Medicare - Experience using payer portals and insurance websites - Strong written and spoken English - Excellent attention to detail and follow-up skills - Ability to work independently and manage multiple patient accounts - Reliable internet connection and a suitable remote workspace Preferred Qualifications - Experience using AdvancedMD - Experience using First Coast SPOT (Florida Medicare), Availity, and the UnitedHealthcare provider portal - Experience supporting internal medicine, hospitalist, wound care, or pain management practices - Familiarity with Florida insurance plans - Experience working a Medicare-heavy A/R and handling Medicare reconsiderations and redeterminations Schedule - Full-time position - Must be available during Eastern Time business hours - Final schedule will be determined based on practice needs Work Arrangement - Remote - Philippines-based applicants preferred Originally posted on Himalayas