Boomerang Healthcare

Accounts Receivable

• Perform timely follow-up on California Medicare, Commercial, and Workers’ Compensation claims to ensure prompt adjudication
• Conduct direct outreach to commercial payers, Medicare contractors, WC adjusters, case managers, and employers to obtain claim status, authorization verification, and documentation requirements
• Resolve claim rejections, underpayments, incorrect fee schedule applications, and missing documentation across payer types
• Track and manage Workers’ Compensation payer-specific timelines, including 30-day status cycles and state-mandated payment rules
• Monitor claims for timely filing, medical necessity, eligibility discrepancies, coordination of benefits, and modifier accuracy
• Coordinate with authorization teams to confirm authorization validity and ensure required documentation is submitted prior to billing
• Escalate delayed or complex cases to appropriate internal team members or external partners
• Identify opportunities for appeal when claims are underpaid or incorrectly denied
• Prepare and submit appeal letters, reconsideration requests, and supporting documentation
• Identify and report recurring denial trends and collaborate with billing, coding, and authorization teams to prevent recurrence
• Assume other responsibilities as appropriate to the position and organizational needs
• Support Boomerang Healthcare’s revenue cycle management operations for multidisciplinary pain-care services

AR Specialist