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AR Specialist
Boomerang Healthcare. Perform timely follow-up on California Medicare, Commercial, and Workers’ Compensation claims to ensure prompt adjudication .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in California Medicare and Commercial billing, with a strong focus on Workers’ Compensation claims management and revenue cycle operations. Proficient in analyzing claim statuses, resolving discrepancies, and collaborating with cross-functional teams to optimize billing processes.
Highest-signal resume keywords
California Medicare BillingWorkers’ Compensation BillingAccounts Receivable Follow-UpEHR / Practice Management SystemsMicrosoft Excel Proficiency
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claim AdjudicationAuthorization VerificationClaim Rejection ResolutionAppeal Letter PreparationNCCI Edits Understanding
Soft Skills
Strong Verbal CommunicationStrong Written CommunicationAttention to DetailCollaboration
Tools & Technologies
IMSNextGenAthenaEClinicalWorksMicrosoft Office
Industry Keywords
Revenue Cycle ManagementMedical NecessityEligibility DiscrepanciesCoordination of BenefitsPayer-Specific Guidelines
About the role
Key responsibilities & impact- 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
Requirements
What you’ll need- High school diploma or GED required
- 3+ years of AR follow-up experience with strong emphasis on California Medicare and Commercial billing
- Working knowledge of Workers’ Compensation billing, including adjuster communication, state rules, medical necessity, and required documentation
- Experience managing mixed payer AR inventories with competing timelines and requirements
- Ability to work in a fast-paced environment, meet daily deadlines, and collaborate with cross-functional RCM teams
- Experience with multiple EHR / Practice Management systems (IMS, NextGen, Athena, eClinicalWorks, or similar)
- Basic understanding of NCCI edits and payer-specific billing guidelines
- Strong verbal and written communication skills; excellent attention to detail
- Advanced proficiency in Microsoft Excel (formulas, pivot tables) and solid skills in other Microsoft Office applications
- Must be available Monday-Friday, 8am-5pm
- Must work 40 hours per week
Benefits
Comp & perks- Amazing work/life balance
- Generous Medical, Dental, Vision, and Prescription benefits (PPO & HMO)
- 401(K) Plan with Employer Matching
- License & Tuition Reimbursements
- Paid Time Off
- Holiday Pay & Floating Holiday
- Employee Perks and Discount Programs
- Supportive environment to help you grow and succeed
- Remote work arrangement