Job Description

The Accounts Receivable (A/R) Specialist is responsible for managing the revenue cycle for behavioral health services, ensuring timely and accurate claims processing, follow-up, and resolution of denied or underpaid claims. This role requires expertise in healthcare billing, regulatory compliance, and reimbursement processes, with a strong emphasis on behavioral health services. The ideal candidate will be proficient in CollaborateMD, Kipu, and payer portals to optimize reimbursement and maintain accurate patient accounts. This Position is full time, on site in person Monday through Friday

Key Responsibilities:

• Process, review, and follow up on insurance claims using CollaborateMD and Kipu.
• Conduct thorough follow-up on unpaid or denied claims to ensure timely reimbursement.
• Investigate and resolve denied or unpaid claims through communication with insurance companies, patients, and internal teams.
• Post payments, adjustments, and refunds accurately.
• Prepare and submit appeals and targeted project files for denied claims.
• Identify problematic claim trends and contract violations, reporting findings to the Revenue Cycle Management (RCM) Manager.
• Contact payers regarding recoupment payments, overpaid accounts, and missing checks; initiate dispute processes as necessary.
• Review underpayments and overpayments, summarize findings, and report to the RCM Manager.
• Maintain detailed and organized records of billing activity and account resolution efforts.
• Update insurance information in patient accounts when necessary.
• Generate A/R reports and assist with month-end closing procedures.
• Work closely with clinical and administrative staff to resolve billing discrepancies.
• Ensure compliance with HIPAA, CMS guidelines, and industry regulations.
• Provide feedback to management and attend departmental meetings/conference calls.
• Perform other duties as assigned.

Qualifications:

• High school diploma or equivalent required.
• 5+ years of medical billing and A/R experience, preferably in behavioral health.
• Strong understanding of Arizona healthcare billing, payer guidelines, and compliance standards.
• Proficiency in CollaborateMD and Kipu is required; familiarity with ADS Medics Premier is preferred.
• Strong knowledge of HCPCS, CPT, ICD-10 coding, medical terminology, and insurance payers.
• Advanced proficiency in Microsoft Excel and Word.
• Excellent organizational, communication, and problem-solving skills.
• Ability to work independently in a fast-paced, high-volume environment.
• Ability to maintain confidentiality and adhere to HIPAA regulations.
• Must have a valid driver's license and be 18 years of age or older.