Senior Payer Accounts Receivable Specialist

Payer A/R Performance:

• Monitor overall payer A/R performance, including aging trends, denial rates, and collection metrics.
• Process and reconcile payments, EOBs, and ERAs, accurately posting to patient accounts and the A/R system.
• Review payer denials and correspondence to identify patterns and recommend process improvements.

Workflow Management:

• Serve as the primary liaison between internal leadership and outsourced billing partners for payer-related workflows.
• Identify and prioritize high-value or at-risk accounts for targeted resolution.
• Coordinate corrected claims, appeals, and retroactive adjustments as needed.

Issue Resolution & Analysis

• Review and escalate unresolved or systemic claim issues (e.g., underpayments, incorrect denials, recurring rejection codes).
• Work with coding, charge entry, and credentialing teams to resolve root causes of denials or payment delays.
• Track payer policy updates and reimbursement changes that impact claim outcomes.