Accounts Receivable Representative III

Interpret Explanation of Benefits (EOBs), EFTs, ERAs, COB, and 835 files with a strong understanding of payer rules including Medicare, Medicaid, Commercial, and Workers' Compensation. Manage healthcare payment posting processes both manually and electronically, ensuring timely and accurate posting of payments.

Job Title: Accounts Receivable Representative III
Location: Nashville, TN
Type: Contract To Hire
Work Model: Hybrid – onsite and remote
Hours: 40.0

Overview
System One is seeking an Accounts Receivable Representative III for an opportunity in Nashville, TN.

Responsibilities

• Manage healthcare payment posting processes both manually and electronically, ensuring timely and accurate posting of payments.
• Interpret Explanation of Benefits (EOBs), EFTs, ERAs, COB, and 835 files with a strong understanding of payer rules including Medicare, Medicaid, Commercial, and Workers' Compensation.
• Resolve complex denials and reconcile unapplied payments efficiently, using knowledge of contractual adjustments, proration logic, and secondary/tertiary payment rules.
• Utilize EMR systems such as Interactant (HCS), WellSky, or other relevant systems to perform payment posting tasks.
• Research payment variances, discrepancies, and incorrect payments, providing accurate resolutions independently.
• Collaborate with billers, collectors, and payers to clarify and resolve payment issues.
• Follow and suggest improvements to internal SOPs and workflows to enhance efficiency.
• Quickly learn and retain knowledge of EMR systems and data reconciliation tools.
• Use Excel and other data tools for payment reconciliation and reporting.

Requirements

• 3-5 years of healthcare payment posting experience (manual and electronic).
• Strong knowledge of EOBs, EFTs, ERAs, COB, and 835 file interpretation.
• Deep understanding of payer rules including Medicare, Medicaid, Commercial, and Workers’ Compensation.
• Familiarity with contractual adjustments, proration logic, and secondary/tertiary payment rules.
• Experience with complex denial resolutions and reconciliation of unapplied payments.
• Knowledge of accounting principles related to revenue cycle and payment reconciliation.
• Proficiency with Excel and data reconciliation tools.
• Experience using payer portals, clearinghouses, and lockbox files.
• Comfortable working with batch files, remittance advice, and custom posting rules.
• Familiarity with automated and manual posting environments and escalation procedures.
• Self-starter with strong problem-solving skills.
• Ability to work under pressure, meet deadlines, and maintain data integrity.
• Strong communication skills for collaboration with multiple departments and payers.
• Ability to learn EMR systems quickly and retain knowledge.

System One, and its subsidiaries including Joulé and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.

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Ref: #431-IT Tampa