AR Recovery & Denials Specialist

Job Position: Medical AR Recovery & Denials Specialist |

About the Role

We’re hiring a Medical AR Recovery & Denials Specialist to help us recover revenue, reduce aged AR, and stop preventable denials before they happen.

If you live for clearing 90+/120+ day buckets, love cracking payer rules, and can prove your impact with real numbers, we want you on the team.

- Own aging reports and drive action on 90+ and 120+ day accounts

- Investigate denials, prepare/submit appeals, and overturn them with payers

- Track recovery metrics: % reduction in DSO, $ recovered, denial overturn rate

- Identify root causes and partner with billing to prevent repeat issues

Billing Software & Revenue Technology

- Work in major EHR/EMR platforms for follow-up, documentation, and posting

- Use clearinghouses: Availity, Waystar, ClaimMD for claim status, ERA, and submissions

- Navigate payer portals for eligibility, status, and appeal requirements

- Build reports and dashboards in Excel using VLOOKUPs and pivot tables

Payer Knowledge & Compliance

- Apply deep knowledge of Medicare, Medicaid, and commercial payer guidelines

- Ensure appeals meet timely filing and payer-specific requirements

- Support prior authorization follow-ups and flag PA-related denial trends

Medical Coding Literacy

- Read and interpret ICD-10-CM, CPT, and HCPCS codes

- Spot coding/modifier errors causing denials — e.g. Modifier 25, NCCI edits

- Collaborate with coding team on education. Certified coder not required — code literacy is key

Recovery Work & Professionalism

- Bring previous dedicated experience in medical AR recovery

- Maintain stable work history and professional communication with payers + internal teams

- Document everything clearly for audits and handoffs

Shift Time: 5.30 TO 2.30 AM ( +/- 1hrs)

Requirements:

3+ years in medical AR recovery/denials. RCM, hospital, or physician practice experience preferred

- Proven metrics: reduced DSO, recovered $ amounts, increased appeal success rate

- Hands-on with EHR/EMR + Availity, Waystar, ClaimMD + payer portals

- Advanced Excel: VLOOKUPs, pivot tables, data analysis for reporting

- Strong grasp of Medicare, Medicaid, and commercial payer rules

- Code-literate in ICD-10-CM, CPT, HCPCS. Ability to identify denial-driving errors

- Detail-oriented, persistent, and excellent at professional written/verbal communication