Medical Accounts Receivable Specialist 2

About the role

The Medical AR Specialist 2 manages complex medical accounts receivable activities with a focus on third-party payer billing, denial resolution, and appeals processing. The role is responsible for ensuring timely follow-up on outstanding claims, resolving payer issues, and maximizing collections while maintaining compliance with billing regulations. This position analyzes denial trends and payer performance, investigates rejected claims, collaborates with internal teams and providers, and supports departmental financial goals such as cash collections and DSO.

Responsibilities

• Manage complex medical accounts receivable activities, focusing on third-party payer billing, denial resolution, and appeals processing.
• Ensure timely follow-up on outstanding claims, resolve payer issues, and maximize collections while maintaining compliance with billing regulations.
• Analyze denial trends and payer performance, investigate rejected claims, collaborate with internal teams and providers, and support departmental financial goals such as cash collections and DSO.
• Collaborate with internal teams and providers to ensure accurate and compliant billing practices.
• Support payer follow-up and collection management, denial investigation, claim correction, and resolution.
• Prepare, submit, track, and evaluate appeals at various levels.
• Identify trends, payer issues, and root causes of denials through analytical skills.
• Contribute to data analysis and reporting of accounts receivable performance and payer activity.
• Solve complex billing or payment discrepancies and prioritize tasks in a fast-paced environment.
• Communicate effectively with payers, providers, and internal stakeholders regarding patient and client accounts.
• Perform accurate data entry, insurance verification, and demographic reviews.

Requirements

• Knowledge of healthcare revenue cycle processes, including billing, claims adjudication, and accounts receivable management.
• Understanding of third-party payer requirements for commercial and government health plans.
• Comprehensive knowledge of medical coding standards including ICD-10, CPT, LCD, and NCD guidelines.
• Experience with denial management and appeals processes across multiple appeal levels.
• Understanding of payer contract terms, reimbursement policies, and payment variance identification.
• Compliance with healthcare regulatory requirements such as HIPAA and billing compliance.
• Experience with accounts receivable performance metrics such as aging, collections, and DSO.
• Proficiency in billing platforms and revenue cycle systems like Xifin or similar.
• Skills in Microsoft Excel and other reporting tools for analyzing AR performance and payer trends.
• Experience with third-party payer follow-up and collection management.
• Experience investigating and resolving denied claims and claim corrections.
• Experience preparing, submitting, and tracking appeals.
• Ability to identify and solve complex billing or payment discrepancies.
• Strong analytical skills for trend identification and issue resolution.
• Effective time management and ability to handle multiple accounts and deadlines.
• Excellent written and verbal communication skills with payers, providers, and internal stakeholders.
• Customer service and inquiry resolution abilities related to patient and client accounts.
• Accurate data entry, insurance verification, and demographic review skills.

Qualifications

• High school diploma or GED equivalent.
• 5–10 years of experience in healthcare revenue cycle, medical billing, or accounts receivable.
• Demonstrated experience with third-party payer follow-up, denial management, and appeals processing.
• Experience resolving complex patient accounts and insurance claim issues.
• Preferably experience in laboratory billing or diagnostic testing environments.
• Experience using revenue cycle management systems such as Xifin or similar platforms.
• Experience analyzing accounts receivable trends, payer performance, and collection outcomes.
• Experience working with payer correspondence, remittance advice, and EOB review for payment accuracy and discrepancies.

Skills

• Knowledge of healthcare revenue cycle processes, including billing, claims adjudication, and accounts receivable management.
• Understanding of third-party payer requirements for commercial and government health plans.
• Comprehensive knowledge of medical coding standards including ICD-10, CPT, LCD, and NCD guidelines.
• Experience with denial management and appeals processes across multiple appeal levels.
• Understanding of payer contract terms, reimbursement policies, and payment variance identification.
• Compliance with healthcare regulatory requirements such as HIPAA and billing compliance.
• Experience with accounts receivable performance metrics such as aging, collections, and DSO.
• Proficiency in billing platforms and revenue cycle systems like Xifin or similar.
• Skills in Microsoft Excel and other reporting tools for analyzing AR performance and payer trends.
• Experience with third-party payer follow-up and collection management.
• Experience investigating and resolving denied claims and claim corrections.
• Experience preparing, submitting, and tracking appeals.
• Ability to identify and solve complex billing or payment discrepancies.
• Strong analytical skills for trend identification and issue resolution.
• Effective time management and ability to handle multiple accounts and deadlines.
• Excellent written and verbal communication skills with payers, providers, and internal stakeholders.
• Customer service and inquiry resolution abilities related to patient and client accounts.
• Accurate data entry, insurance verification, and demographic review skills.

Benefits

Not specified.

Pay

The annualized base salary range for this role is $48,800 to $73,300 and is bonus eligible. Final compensation packages will ultimately depend on factors including relevant experience, skillset, knowledge, geography, education, business needs and market demand.

Schedule

Not specified.

Equal Opportunity Employer

Hologic, Inc. is proud to be an Equal Opportunity Employer inclusive of disability and veterans.

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