Job Description

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. The specialist works independently on complex accounts while escalating advanced appeals and systemic payer issues when needed.

Knowledge

• Healthcare revenue cycle processes, including billing, claims adjudication, and accounts receivable management
• Third‑party payer requirements for commercial and government health plans
• Medical coding standards including ICD‑10, CPT, LCD, and NCD guidelines
• Denial management and appeals processes across multiple appeal levels
• Payer contract terms, reimbursement policies, and payment variance identification
• Healthcare regulatory requirements including HIPAA and billing compliance
• Accounts receivable performance metrics such as aging, collections, and DSO
• Billing platforms and revenue cycle systems (e.g., Xifin or similar)
• Microsoft Excel and reporting tools for analyzing AR performance and payer trends

Skills

• Third‑party payer follow‑up and collection management
• Denial investigation, claim correction, and resolution
• Appeals preparation, submission, tracking, and outcome evaluation
• Analytical skills for identifying trends, payer issues, and root causes of denials
• Data analysis and reporting of AR performance and payer activity
• Problem solving and troubleshooting complex billing or payment discrepancies
• Time management and ability to manage multiple accounts and deadlines
• Effective written and verbal communication with payers, providers, and internal stakeholders
• Customer service and inquiry resolution related to patient and client accounts
• Accurate data entry, insurance verification, and demographic review

Behaviors / Competencies

• Self‑motivated and able to work independently with minimal supervision
• Detail‑oriented with strong focus on accuracy and compliance
• Analytical and proactive in identifying and resolving issues affecting collections
• Organized and able to prioritize tasks in a fast‑paced environment
• Collaborative team member who contributes insights and supports cross‑training
• Adaptable to changing business needs and workloads
• Persistent and solution‑focused when addressing complex payer issues
• Professional, respectful, and service‑oriented in interactions with stakeholders

Experience

• 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 AR trends, payer performance, and collection outcomes
• Experience working with payer correspondence, remittance advice, and EOB review for payment accuracy and discrepancies

Ready to make a difference in women’s health? Apply today and join our team of passionate innovators at Hologic!

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.

Agency And Third Party Recruiter Notice: Agencies that submit a resume to Hologic must have a current executed Hologic Agency Agreement executed by a member of the Human Resource Department. In addition, Agencies may only submit candidates to positions for which they have been invited to do so by a Hologic Recruiter. All resumes must be sent to the Hologic Recruiter under these terms or they will not be considered.

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

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