Accounts Receivable Specialist – Medical Billing Experience

Netsmart

. Manage a portfolio of outstanding insurance accounts receivable, ensuring timely follow-up and resolution of unpaid or underpaid claims .

Posted 9/23/2026full-timeRemote • United StatesJuniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing healthcare accounts receivable and denial management, with a strong focus on analyzing reimbursement trends and improving claim resolution processes. Proficient in utilizing advanced Microsoft Excel and communication tools to enhance productivity and maintain compliance with billing regulations.

Highest-signal resume keywords

Healthcare Accounts Receivable ManagementDenial Management ExperienceAdvanced Microsoft Excel SkillsInsurance Reimbursement ProcessesAnalytical and Problem-Solving Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Denial ManagementClaim ResearchReimbursement AnalysisClaims Follow-UpElectronic Data Interchange (EDI)Medical BillingClaims AdjudicationSpreadsheet ManagementFormal Appeals PreparationRevenue Cycle Management

Soft Skills

Verbal CommunicationWritten CommunicationCritical ThinkingIndependenceProductivity Management

Tools & Technologies

Microsoft ExcelMicrosoft OutlookRPA ToolsAI-Assisted WorkflowsMedical Billing Systems

Industry Keywords

Healthcare Revenue CycleMedicareMedicaidBehavioral Health BillingPost-Acute Care BillingHome Health BillingLong-Term Care BillingCommercial Payer Requirements

Tech Stack

Tools & technologies

RPA

About the role

Key responsibilities & impact

Manage a portfolio of outstanding insurance accounts receivable, ensuring timely follow-up and resolution of unpaid or underpaid claims
Perform end-to-end denial management, including researching claim denials, identifying root causes, submitting appeals, and securing appropriate reimbursement
Analyze denial patterns and reimbursement trends to identify opportunities for process improvement and revenue recovery
Contact insurance carriers via phone, email, fax, payer portals, and written correspondence to resolve claim issues and payment delays
Investigate and resolve claim edits, rejections, authorization issues, coding discrepancies, and payer-specific reimbursement concerns
Follow up on aged accounts and claims with no response from insurance carriers while maintaining productivity and quality standards
Use Microsoft Excel to track accounts, analyze payer trends, manage work queues, create reports, and maintain denial inventories
Use Microsoft Outlook extensively for communication with payers, clients, and internal stakeholders regarding claim resolution activities
Review and apply current federal, state, Medicare, Medicaid, and payer-specific billing regulations
Handle Electronic Data Interchange (EDI) transactions, including reconciliation of carrier submissions, clearinghouse edits, and rejection reports
Leverage RPA tools and AI-assisted workflows to enhance efficiency, automate routine follow-up activities, and improve claim resolution outcomes
Maintain detailed documentation of account activity and claim resolution efforts

Requirements

What you’ll need

High school diploma or GED
Minimum of 1 year of healthcare accounts receivable, medical billing, or denial management experience
Demonstrated experience researching and resolving insurance claim denials and payer reimbursement issues
Advanced Microsoft Excel skills, including VLOOKUPs/XLOOKUPs, Pivot Tables, filters, formulas, and spreadsheet management
Strong proficiency in Microsoft Outlook, including managing high-volume email communications and claim follow-up correspondence
Understanding of insurance reimbursement processes, claim adjudication, Medicare, Medicaid, and commercial payer requirements
Strong analytical, critical thinking, and problem-solving skills
Excellent verbal and written communication skills
Demonstrated ability to manage productivity metrics and work independently in a fast-paced environment
All applicants must be legally authorized to work in the United States
Netsmart does not provide work visa sponsorship for this position
Preferred: Experience in behavioral health, post-acute care, home health, long-term care, or specialty healthcare billing
Preferred: 2+ years of insurance AR follow-up and denial management experience
Preferred: Collections experience within a healthcare revenue cycle environment
Preferred: Experience preparing and submitting formal appeals to insurance carriers
Preferred: Working knowledge of medical billing systems such as Medic, IDX, Avatar, Tier, Medical Manager, or similar platforms
Preferred: Experience with automation tools, AI-enabled workflows, or revenue cycle technology solutions

Benefits

Comp & perks

Equal employment and advancement opportunities
Pre-employment background check and drug screen provided at Netsmart’s sole expense