Accounts Receivable Escalations Specialist

Essential Responsibilities

• Manage accounts aged 70+ days or identified as payment risk.
• Resolve complex payer issues requiring advanced research.
• Prioritize high-balance accounts impacting cash flow.
• Perform high-level payer outreach and escalation conversations.
• Cookordinate resolution for stalled, rejected, or repeatedly denied claims.
• Drive accounts to final disposition (paid, adjusted, or escalated legally).
• Lead second-level and executive appeals.
• Execute targeted recovery strategies on aged inventory.
• Identify recurring revenue cycle breakdowns and provide structured feedback.
• May be required to conduct and/or participate in training sessions at the office level.
• Participate in special projects as assigned.

Essential Skills

• Extremely detail oriented.
• Comprehend all issues and articulate them to relevant parties.
• Revenue ownership mindset and Escalation judgment.
• Problem solving and organizational skills with Critical thinking.
• Reliability, Accuracy and Efficiency when dealing with patients or third-party payors.
• Persistence and negotiation ability.
• Operational accountability.
• Work independently with minimal supervision and be result oriented.
• React to frequent changes in duties and volume of work.
• Excellent oral and written communication skills.
• Effective interpersonal skills, including the ability to promote teamwork.
• Strong problem-solving skills.
• Ensure a high level of customer satisfaction including employees, patients, physicians, and external stakeholders.
• Maintain confidentiality of sensitive information.

Education and Experience

• High School Diploma
• 3+ years of healthcare Accounts Receivable experience
• Advanced payer follow-up and denial resolution expertise
• Knowledge of reimbursement methodologies
• Strong analytical and investigative skills
• Ability to manage complex account portfolios

Preferred Qualifications

• Escalations or complex A/R specialization
• Multi-specialty or MSO experience
• Appeals and payer negotiation experience
• Experience with Athena, Epic, eClinicalWorks, or similar PM systems
• Minimal travel