RCM Associate - Insurance AR Specialist - Remote

Under the direction of the RCM Supervisor
- Back End the RCM Associate
- Insurance AR Specialist is responsible for managing assigned insurance accounts receivable, resolving outstanding payer balances, addressing denials, and supporting timely reimbursement from third-party payers. This role supports revenue optimization, payer compliance, denial prevention, and accurate documentation of claim follow-up activity. Organization, attention to detail, prioritization, problem solving, and multitasking are necessary to ensure a high level of service to patients, physicians, payers, vendors, and OO staff.

• Review, prioritize, and work assigned insurance accounts receivable by payer portfolio, aging category, balance, and department priority.
• Investigate and resolve unpaid, delayed, denied, underpaid, or incorrectly processed claims.
• Monitor payer payment trends, aging buckets, and unresolved balances to identify barriers to timely reimbursement.
• Identify payer denials, rejections, slow payment patterns, and recurring claim issues and escalated trends to leadership.
• Support reduction of aged AR by working accounts timely and documenting clear, actionable follow-up notes in the practice management system.

• Review payer denials and coordinate with Coding, Precertification, Charge Entry, Denial Management, and other RCM teams to resolve account issues.
• Submit corrected claims, appeals, reconsiderations, medical records, or additional documentation as needed based on payer requirements.
• Track payer responses, appeal outcomes, corrected claim status, and next steps in Athena or other approved PM/EMR systems.
• Follow up on outstanding insurance balances using payer portals, clearinghouse tools, phone calls, written correspondence, and internal work queues.
• Identify authorization, eligibility, coding, demographic, modifier, medical necessity, timely filing, and documentation-related issues that affect payment.

• Contact payers professionally by phone, portal, or written correspondence to resolve claim disputes and secure appropriate reimbursement.
• Maintain professional communication with payer representatives, patients, internal team members, and leadership.
• Escalate unresolved payer issues, systemic denial trends, underpayment patterns, or contract-related concerns to RCM leadership or appropriate internal teams.
• Collaborate with Revenue Integrity, Contracting, Coding, Precertification, Front End, and Payment Posting teams to resolve root causes and prevent repeat AR issues.

• Ensure all activities comply with payer guidelines, government regulations, HIPAA requirements, and internal revenue cycle policies.
• Maintain complete, accurate, and audit-ready documentation for all claim resolution actions, payer communications, appeals, and account updates.
• Track daily productivity, AR aging performance, denial resolution activity, appeal outcomes, and assigned workqueue progress.
• Participate in AR team huddles, payer meetings, denial trending reviews, workflow improvement initiatives, and special projects as assigned.
• Recommend process improvements to enhance AR turnaround, collections efficiency, documentation quality, and denial prevention.
• Perform other duties as assigned.

This job has no formal supervisory responsibilities. The RCM Associate
- Insurance AR Specialist may assist with training new team members, sharing workflow updates, supporting AR education, and serving as a resource for assigned payer or account follow-up processes as directed by leadership.

Customer Service
- Works well with patients,…