Accounts Receivable Specialist - Complex - Hybrid; Earth MO

Location: Earth City, MO 63045 (Hybrid – 1 day per week from home)

Schedule: Monday – Friday, 8:00 AM – 5:00 PM CST (Flexible)

Training: 2 weeks, Monday – Friday, 8:00 AM – 5:00 PM CST

Start Date: 10/26

Experience: 5+ years in healthcare revenue cycle

The Complex Accounts Receivable Resolution Specialist is responsible for independently investigating and resolving high-complexity physician accounts receivable that are considered difficult to resolve through standard follow-up processes. This role requires advanced revenue cycle knowledge, strong analytical judgment, and the ability to research payer requirements, interpret reimbursement data, identify root causes, and pursue the appropriate resolution strategy through final account disposition. The position supports Cognizant's commitment to operational excellence, financial recovery, client satisfaction, compliance, and continuous process improvement.

This position serves as a senior-level contributor responsible for resolving complex, aged, denied, underpaid, or otherwise challenging AR inventory. The specialist is expected to apply independent critical thinking, validate prior account activity, determine whether additional reimbursement opportunity exists, and take the appropriate actions to support timely and accurate revenue recovery for Cognizant clients.

• Manage and resolve complex physician AR inventory, including aged accounts, denials, underpayments, payment variances, reimbursement discrepancies, and claims requiring advanced follow-up.
• Follow up directly with insurance companies to resolve outstanding claims, denials, underpayments, and payment variances.
• Prepare, submit, and follow through on technical and clinical appeals.
• Independently navigate payer portals to research claims, obtain payment information, upload documentation, and complete payer-specific requirements.
• Accurately document all payer contacts, reference numbers, findings, actions taken, and next steps.
• Prioritize outstanding AR based on aging, financial impact, denial type, payer requirements, and recovery opportunity.
• Identify root causes of denials, underpayments, and payment delays and determine appropriate corrective action.
• Resolve accounts efficiently with a focus on maximizing reimbursement and minimizing unnecessary touches.
• Track and trend claim denials and underpayments to identify payer, process, technology, and workflow improvement opportunities.
• Identify trends across payers, providers, Tax IDs, CPTs, modifiers, denial codes, reason codes, and reimbursement outcomes.
• Communicate findings, financial impact, and recommendations to leadership.
• Make recommendations for additions, revisions, or deletions to work queues, claim edits, workflows, and processes to improve efficiency and reduce denials.
• Serve as a resource for complex AR scenarios by applying independent research, sound judgment, and payer-specific knowledge to determine the best course of action.
• Support Cognizant leadership by escalating confirmed systemic issues, payer barriers, workflow gaps, and financial risk items with clear documentation and recommended next steps.

• 5+ years of healthcare revenue cycle experience, preferably in physician AR, collections, or denial management.
• Strong working knowledge of the healthcare revenue cycle.
• Strong knowledge of medical terminology, CPT/HCPCS codes, modifiers, diagnosis codes, NCCI edits, reimbursement methodologies, and payer-specific requirements.
• Strong knowledge of state and federal billing guidelines, payer policies, reimbursement methodologies, and claim adjudication requirements.
• Demonstrated ability to interpret and apply payer…