Accounts Receivable Specialist
On-site · Southfield, Michigan, United States
Job Summary
Accounts Receivable Specialist in a large orthopedic practice responsible for managing patient and insurance balances, submitting corrected claims and appeals, and maintaining accurate AR records. Primary duties include following up on unpaid, denied, and underpaid claims via phone, payer portals, and written correspondence; resolving denials and coordination-of-benefits issues; submitting corrected claims and supporting documentation to carriers; maintaining detailed documentation of collections and follow-up actions; and ensuring timely reimbursement while meeting productivity, quality, and collection targets. Requires strong knowledge of medical billing concepts (CPT, ICD-10-CM, HCPCS), EOBs/EOPs/ERAs, COB concepts, and HIPAA compliance; emphasizes professional communication with insurance companies, patients, and internal staff, along with experience in an orthopedic or specialty medical practice. Proficiency with EMR and practice management systems is preferred.
Required Qualifications
- High school diploma or equivalent required; Associate’s or Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field preferred
- Two years of accounts receivable experience in a medical practice setting preferred
- Proficient knowledge of CPT, ICD-10-CM, HCPCS coding systems
- Experience with medical claims in orthopedic or specialty practice preferred
- HIPAA compliance knowledge
- Strong communication and customer service skills
- Experience with EOBs/EOPs/ERAs
- EMR and practice management systems experience preferred
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