Job Summary

RCM Staff BPO is hiring a full-time Accounts Receivable (A/R) and Denial Management Specialist to support a multi-specialty physician group based in Florida.

You will review claims for accuracy before submission, work aged A/R, and resolve denials so the practice gets paid faster and with fewer rejections. This role requires strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans, especially Medicare.

Key Responsibilities

• Review pending and unbilled claim buckets in the practice management system for accuracy before submission
• Correct eligibility, wrong-payer, demographic, and coding-related errors so claims are paid on the first submission
• Verify patient eligibility and confirm the correct primary and secondary insurance
• Follow up on unpaid, underpaid, and aged claims through payer portals and phone calls
• Research denials, identify the root cause, and submit corrected claims, reconsiderations, or appeals
• Check claim status and resolve issues using Medicare, Availity, and UnitedHealthcare portals
• Document all follow-up activity and next steps clearly in the practice management system
• Report recurring denial trends and payer issues to the billing manager
• Work alongside the practice’s in-house A/R team and meet daily productivity targets
• Protect patient information and follow HIPAA requirements

Qualifications

• At least 2 years of experience with U.S. healthcare A/R follow-up and denial management
• Experience reviewing claims for accuracy and resolving eligibility and payer errors
• Familiarity with commercial insurance and government health plans, including Medicare
• Experience using payer portals and insurance websites
• Strong written and spoken English
• Excellent attention to detail and follow-up skills
• Ability to work independently and manage multiple patient accounts
• Reliable internet connection and a suitable remote workspace

Preferred Qualifications

• Experience using AdvancedMD
• Experience using First Coast SPOT (Florida Medicare), Availity, and the UnitedHealthcare provider portal
• Experience supporting internal medicine, hospitalist, wound care, or pain management practices
• Familiarity with Florida insurance plans
• Experience working a Medicare-heavy A/R and handling Medicare reconsiderations and redeterminations

Schedule

Full-time position

Must be available during Eastern Time business hours

Final schedule will be determined based on practice needs

Work Arrangement

Remote

Philippines-based applicants preferred