Revenue Cycle Account Reimbursement Specialist CLONE MF

Revenue Cycle Account Reimbursement Specialist Position OverviewA growing healthcare organization is seeking an experienced Account Reimbursement Specialist II to support its revenue cycle operations. This position is responsible for resolving complex insurance claims, analyzing denial trends, submitting appeals and reconsiderations, and ensuring timely, accurate reimbursement.The ideal candidate has strong medical billing knowledge, understands payer requirements, and is comfortable collaborating with clinical and revenue cycle teams to address issues affecting billing and collections. M-F; 8a-5pKey ResponsibilitiesServe as a billing resource for assigned departments, answering questions related to payer requirements, denials, and patient accountsFollow up on unpaid and underpaid insurance claims to support timely collectionResearch claim issues and complete corrections, reconsiderations, and appealsReview and interpret explanations of benefits to ensure claims and payments are reconciled correctlyIdentify trends involving denials, underpayments, and overpaymentsPartner with coding, charge capture, insurance verification, and reimbursement teams to resolve billing issuesRecommend process improvements that strengthen revenue cycle performance and reduce preventable denialsCoordinate medical-record requests and process insurance and patient correspondenceCommunicate with patients and insurance payers to research and resolve payment-related inquiriesManage and resolve billing cases within AthenaHealthCollaborate with clinic managers and revenue cycle staff to improve procedures and workflowsParticipate in departmental workgroups and provide feedback regarding payer denials, system issues, and claims activityPerform additional responsibilities as assignedQualificationsAt least three years of complex claims follow-up experience within a physician practice, hospital, ambulatory surgery center, or centralized medical billing officeKnowledge of commercial insurance, HMO/PPO plans, Medicare, Medicaid, and payer reimbursement guidelinesExperience reviewing denials and preparing claim appeals and reconsiderationsAbility to interpret payer explanations of benefitsWorking knowledge of medical terminology, ICD-10, and CPT codesStrong organizational and time-management skillsAbility to meet established productivity and accuracy standardsExcellent verbal communication and customer-service skillsProficiency with Microsoft Word and ExcelAthenaHealth experience is preferredEducationHigh school diploma or equivalent requiredAssociate degree in business, healthcare administration, or a related field is strongly preferred