Lead Accounts Receivable Claims Specialist (Chesapeake Specialty Care)
$44,200–$66,400 year
RemoteUnited States
Job Summary
Lead and coordinate the daily workflow of the Accounts Receivable Claims team, overseeing complex denial resolution activities and appeals. Serve as the subject matter expert for claim denials, payer follow-up, and reimbursement issues, providing guidance to team members while monitoring department performance and identifying denial trends. Review and resolve complex claim denials, underpayments, and reimbursement discrepancies by communicating with providers to obtain necessary documentation and resubmitting corrected claims based on payer policies. Stay current on payer policies, coverage guidelines, and appeal processes to ensure proper claim adjudication and maximize revenue cycle performance.
Required Qualifications
- High school diploma or equivalent
- Associate degree in Healthcare Administration, Business, or a related field preferred
- 4–5 years of experience in medical billing, accounts receivable, or denial management
- 1–2 years of leadership, supervisory, mentoring, or team lead experience preferred
- Strong knowledge of medical insurance plans including commercial, Medicare, Medicaid, and Tricare
- Advanced understanding of claims adjudication, denial management, appeals, and reimbursement methodologies
- Familiarity with medical terminology and CPT/ICD-10 codes
- Experience with practice management systems and EHR platforms
- Strong knowledge of medical coding concepts and third-party payer operations
- Excellent communication and customer service skills
- Strong analytical, problem-solving, and critical-thinking abilities
- Familiarity with Microsoft applications, including but not limited to Word and Excel
- Strong written and verbal communication skills, including the ability to confidently communicate with patients, providers, insurance representatives, and staff
- Excellent organizational skills to manage multiple tasks, priorities, and deadlines
- Demonstrated ability to work as a team player in a collaborative medical practice environment
- Ability to communicate and work well with co-workers through open and honest communication
- Ability to effectively communicate orally and in writing with internal and external business professionals
- Must be responsible, reliable, and able to carry out job functions with minimal supervision
- Demonstrated leadership skills with the ability to mentor staff and drive departmental performance improvements
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