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Remote AR Specialist – Medicare and Workers’ Compensation Claims
Boomerang Healthcare seeks a remote AR Specialist to manage California Medicare, Commercial, and Workers’ Compensation claims within its multidisciplinary pain-care services. The role focuses on payer follow-up, denial resolution, appeals, and reimbursement improvement.
विवरण
- Follow up promptly on California Medicare, Commercial, and Workers’ Compensation claims to support timely adjudication
- Contact commercial payers, Medicare contractors, WC adjusters, case managers, and employers to verify claim status, authorizations, and documentation needs
- Resolve payer rejections, underpayments, fee schedule errors, and missing documentation
- Manage Workers’ Compensation timelines, including 30-day status cycles and state-mandated payment requirements
- Review claims for timely filing, medical necessity, eligibility issues, coordination of benefits, and modifier accuracy
- Work with authorization teams to validate approvals and submit required documentation before billing
- Escalate delayed or complex claims to the appropriate internal teams or external partners
- Evaluate underpaid or incorrectly denied claims for appeal opportunities
- Draft and submit appeal letters, reconsideration requests, and supporting records
- Analyze recurring denial patterns and partner with billing, coding, and authorization teams on prevention
- Take on additional duties aligned with the role and organizational needs
- Support revenue cycle management for Boomerang Healthcare’s multidisciplinary pain-care services
आवश्यकताएँ
- High school diploma or GED
- At least three years of AR follow-up experience, particularly with California Medicare and Commercial billing
- Working knowledge of Workers’ Compensation billing, including adjuster communication, state requirements, medical necessity, and documentation
- Experience managing mixed-payer AR inventories with competing deadlines and requirements
- Ability to work quickly, meet daily deadlines, and collaborate with cross-functional RCM teams
- Experience using multiple EHR or practice management systems, such as IMS, NextGen, Athena, eClinicalWorks, or similar platforms
- Basic knowledge of NCCI edits and payer-specific billing guidelines
- Strong written and verbal communication with excellent attention to detail
- Advanced Microsoft Excel skills, including formulas and pivot tables, plus proficiency with other Microsoft Office applications
- Availability Monday through Friday, 8 a.m. to 5 p.m.
- Ability to work 40 hours per week
लाभ
- Work-life balance
- Medical, dental, vision, and prescription coverage with PPO and HMO options
- 401(k) plan with employer matching
- License and tuition reimbursement
- Paid time off
- Holiday pay and floating holiday
- Employee perks and discount programs
- Supportive environment for professional growth and success
- Remote work arrangement
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