Lead Aging Account Receivable Specialist

About the Role

The Lead Aging Accounts Receivable Specialist oversees the follow-up and resolution of outstanding patient and payer balances to support the financial health of Park West Health System. This role monitors aging reports, prioritizes high-risk accounts, and leads complex claim resolution efforts to ensure timely reimbursement and reduction of uncompensated care. The Lead Specialist serves as a subject matter expert on denial management, payer trends, and accounts receivable workflows, providing guidance to team members and collaborating with billing, front-end, and clinical teams to address root causes of billing delays.

Responsibilities

• Monitor aging reports to identify delinquent accounts and take appropriate action to collect outstanding balances.
• Serve as an advocate to troubleshoot problems within the Medical Registration area that can cause billing delays in reimbursement.
• Responsible for the daily charge entry of the Billing Department for all patient accounting and related functions, including accounts receivable, billing, credit, and collections.
• Prepare and submit billing to insurance companies or other payers.
• Follow up on delinquent claims and past-due invoices.
• Manage Medicare and Medicaid claims.
• Use coded data to produce claims to insurance companies.
• Review and appeal denied and unpaid claims.
• Verify patient insurance coverage and answer patient billing questions.
• Maintain assigned receivables through work queues, age trail balance reports (ATBs), and special projects to achieve departmental goals.
• Ensure correct processing of outstanding insurance claims by:
  • Interpreting insurance payer responses.
  • Requesting account-level adjustments.
  • Submitting appeals and claims reconsiderations.
  • Evaluating financial responsibility of patients.
  • Resolving insurance denials and claim rejections.
  • Performing insurance verification.
• Assist with Front Desk Registrar duties as needed to support clinic operations and ensure seamless patient flow.
• Provide courteous, responsive, and service-oriented support to patients, visitors, and colleagues.
• Promote a respectful and welcoming environment, communicate clearly, and collaborate to support team and organizational goals.
• Perform duties in alignment with Park West Health System’s mission, vision, and values.
• Adhere to federal, state, and local regulations, including HIPAA, privacy, and security standards.
• Follow infection control, workplace safety, and risk management protocols.
• Participate in quality improvement and performance initiatives.
• Maintain professionalism, reliability, and accountability in attendance, performance, and communication.
• Complete required trainings, participate in staff meetings, and support organizational initiatives.
• Perform other duties as needed.

Qualifications

• High school diploma or equivalent required.
• Minimum of five (5) years of experience in a medical billing or revenue cycle environment required.
• Minimum of five (5) years of experience in customer service, patient relations, or a related healthcare support role required.
• Experience working in a Federally Qualified Health Center (FQHC) or community health setting preferred.
• Experience using electronic health record (EHR) and practice management systems required.
• Working knowledge of medical terminology obtained through formal training or relevant work experience required.
• Proficiency with computer systems, including electronic billing and practice management platforms, required.

Skills

• Advanced knowledge of accounts receivable follow-up, denial management, and payer resolution strategies.
• Strong analytical skills with the ability to identify trends, root causes, and process improvement opportunities.
• Ability to interpret explanation of benefits (EOBs), remittance advice, and payer correspondence accurately.
• Excellent organizational and time-management skills with the ability to manage large volumes of accounts and competing priorities.
• Strong problem-solving skills with the ability to independently resolve complex billing issues.