Accounts Receivable Specialist – Urology | Permanent WFH

e are seeking an experienced Accounts Receivable (AR) Specialist with a strong background in medical billing, insurance follow-up, and aged accounts receivable, preferably within a urology practice or specialty healthcare setting.The ideal candidate will have hands-on experience managing aged insurance accounts, resolving unpaid and underpaid claims, working denials and appeals, and following accounts through final resolution. This role requires a strong understanding of both professional and surgical claims, including services provided in office, outpatient, ambulatory surgery center, and inpatient hospital settings.The successful candidate will be comfortable communicating directly with commercial insurance carriers, Medicare, Medicaid, and patients, while researching complex billing issues, identifying the root cause of unpaid claims, and taking the appropriate steps to secure reimbursement.Key ResponsibilitiesAccounts Receivable & Insurance Follow-UpManage assigned aged accounts receivable, prioritizing outstanding insurance and patient balances based on account age, balance, payer, denial reason, and timely filing requirements.Work accounts aged 60, 90, 120+ days and take appropriate action to prevent further aging.Contact commercial insurance carriers, Medicare, Medicaid, and other payers regarding unpaid, delayed, denied, or underpaid claims.Research claim status, payment discrepancies, denials, rejections, billing errors, and payer processing issues.Identify the root cause of outstanding balances and determine the appropriate next action for resolution.Follow accounts through final resolution rather than stopping after initial payer follow-up.Maintain consistent follow-up schedules and ensure no accounts are unnecessarily left unresolved.Claims, Denials & AppealsSubmit corrected claims, reconsiderations, appeals, and supporting documentation as required.Research and resolve claim denials, rejections, underpayments, and other payer issues.Obtain and submit medical records, operative reports, prior authorization information, NDC information, and other documentation requested by payers.Review EOBs, ERAs, payer correspondence, and claim status information to determine appropriate next steps.Identify recurring denial and payment trends and escalate systemic issues when appropriate.Review CPT, ICD-10-CM, modifiers, and other coding information when investigating claim issues.Urology BillingWork both professional and surgical claims related to urology services.Manage accounts associated with:Office visits and consultationsDiagnostic urology proceduresCystoscopy and related proceduresUrologic surgical proceduresProstate proceduresBladder proceduresKidney and ureter proceduresStone management proceduresIncontinence proceduresCatheter-related servicesInpatient and outpatient surgical careAmbulatory surgery center servicesPostoperative and follow-up careUnderstand billing considerations associated with urologic surgical procedures, diagnostic services, office procedures, and postoperative care.Review complex or high-dollar surgical claims and determine appropriate resolution strategies.Patient Accounts & CommunicationCommunicate directly with patients regarding outstanding balances, insurance processing, billing questions, financial responsibility, and payment options.Establish appropriate payment arrangements when applicable.Research and resolve patient account discrepancies professionally and accurately.Serve as a liaison between patients, insurance companies, clinical staff, coding, billing, and internal departments.Documentation & Payment PostingDocument all payer and patient communications accurately within the EMR or practice management system.Maintain detailed account notes including actions taken, payer responses, reference numbers, claim status, and next follow-up dates.Review and post insurance and patient payments when required.Ensure payments, adjustments, contractual allowances, and account information are posted accurately.Maintain compliance with HIPAA, payer requirements, billing regulations, and organizational policies.QualificationsMinimum 1–2 years of experience in medical accounts receivable, insurance follow-up, or medical billing.Previous urology billing or accounts receivable experience strongly preferred.Demonstrated experience managing aged insurance accounts, including 60-, 90-, and 120+ day AR.Proven experience communicating directly with insurance carriers to resolve outstanding claims.Hands-on experience with denials, underpayments, rejected claims, corrected claims, reconsiderations, and appeals.Working knowledge of CPT and ICD-10-CM coding.Ability to read and interpret EOBs, ERAs, payer correspondence, and claim status information.Proficiency in Microsoft Office and standard healthcare billing/practice management systems.Previous experience in a urology practice or urology medical billing environment.Experience with both inpatient and outpatient urology services.Experience working claims involving urologic surgical procedures.Experience with physician professional billing and ambulatory surgery center or hospital-based claims.Experience working with Medicare, Medicaid, and commercial insurance carriers.Experience handling prior authorization and medical-necessity-related denials.Experience with AthenaOne/Athenahealth.Experience managing complex or high-dollar surgical claims.PerksPermanent Work From HomeLeave CreditsMonetary AllowanceAnnual BonusWeekly PaychecksFixed Weekends OffThriving Company Culture with Complete AutonomyExclusive Specialized Training ProgramsUnlock Your Potential with a Highly Competitive Salary____________________________________________________________________Who are we?BizForce is one of the fastest-growing global outsourcing companies in the world, founded in the US in Tucson, Arizona and is now operational in PH!Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.