High-Volume Accounts Receivable Specialist

High-Volume Accounts Receivable Specialist

Remote

Accounts Receivable Specialist

Reports To: Lead Revenue Cycle

Locations Hiring From: Arizona, Delaware, Florida, Georgia, Idaho, Indiana, Louisiana, Minnesota, Missouri, New Hampshire, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Vermont, Virginia ONLY.

Must currently reside and plan on residing in the entire employment.

Schedule: Monday
- Friday 9-6pm EST

Employment Type: Full-Time

Role Overview

As an Account Receivable Specialist, you will be responsible for managing insurance accounts receivable and ensuring accurate, timely posting and reconciliation of payments. This role focuses on maximizing reimbursement through proactive claim follow-up, denial resolution, payment investigation, and cash reconciliation. You will work closely with our Revenue Cycle leads, other members of the Revenue Cycle team, finance, and clinical teams to resolve payment discrepancies, improve AR performance, and maintain accurate financial records.

This role also supports reporting and identifies trends to improve revenue cycle processes and overall financial performance. Your attention to detail, excellent organizational skills, and commitment to customer access will contribute to the financial stability and success of Oshi as we pioneer the way in GI care.

What You'll Do:
Key Responsibilities

• Manage assigned insurance accounts receivable to ensure timely reimbursement and reduce aging balances.
• Follow up with insurance payers on outstanding claims, underpayments, denials, and payment discrepancies.
• Investigate and resolve claim denials by submitting corrected claims, appeals, reconsiderations, and supporting documentation in accordance with payer requirements.
• Review claim edits and rejections to ensure accurate resubmission and minimize future denials.
• Accurately post insurance payments, adjustments, and remittances into the billing system.
• Perform daily payment reconciliation by ensuring posted payments align with electronic remittance advice (ERA), explanation of benefits (EOB), bank deposits, and payment reports.
• Research and resolve unapplied cash, payment variances, over payments, and underpayments.
• Reconcile payer payments against contracted reimbursement rates and elevate payment discrepancies as appropriate.
• Maintain accurate documentation of AR activities, payer communications, payment research, and resolution outcomes.
• Respond professionally and empathetically to patient inquiries regarding insurance claims, billing statements, payment activity, balances, and Oshi's billing model, policies, procedures, and applicable healthcare regulations.
• Maintain open communication with providers, payers, and internal stakeholders to investigate, resolve, and prevent claim and payment issues.
• Collaborate with Eligibility & Benefits, Credentialing, Finance, Clinical Operations, and other cross-functional teams to resolve reimbursement issues and improve revenue cycle performance.
• Analyze accounts receivable, payment, and denial data to identify trends, root causes, and opportunities for process improvement.
• Monitor and report on AR performance, payment posting accuracy, denial trends, aging, and other key revenue cycle metrics, providing insights and recommendations to leadership.