Accounts Receivable Specialist

Accounts Receivable Specialist

Washington, District of Columbia, United States

Position Purpose

The Accounts Receivable Specialist is responsible for managing the full cycle of accounts receivable processes to ensure accurate and timely collection of payments. This role oversees the invoicing of clients, reconciliation of accounts, payment posting, and resolution of billing discrepancies. The specialist communicates regularly with internal teams and external customers to address outstanding balances, verify account information, and support efficient cash flow operations. A strong attention to detail, excellent organizational skills, and the ability to work in a deadline-driven environment are essential for success in this position.

Essential Functions

Customer Service & Communication

• Answer incoming phone calls and respond to insurance and patient balance inquiries in a professional and timely manner.
• Communicate with patients, insurance carriers, and internal team members to resolve billing issues and clarify account details.
• Write clear and accurate narratives when insurance carriers request additional information.

Claims Processing & Follow-Up

• Process insurance claim denials and resubmit claims with the necessary supporting documentation.
• Maintain timely resolution of all open claims reflected on the monthly aged trial balance report.
• Retrieve clearing house reports daily, identify rejected claims, and resubmit them as needed.
• Attach all required documentationincluding X-rays, narratives, and anesthesia recordsprior to claim submission.
• Review subscriber and patient information for accuracy prior to claim submission.

Accounts Receivable Management

• Monitor and manage the full accounts receivable cycle to ensure timely follow-up on outstanding balances.
• Research and investigate reimbursement discrepancies, including out-of-network and contractual issues.
• Analyze accounts for recurring denial trends or underpayments and escalate findings to management.

Payment Posting & Reconciliation

• Post insurance and patient payments accurately, both manually and electronically.
• Reconcile daily, weekly, and monthly financial transactions, including payment batches and adjustments.
• Process patient refunds and generate monthly patient statements.

Documentation & Compliance

• Maintain accurate and organized documentation for all claims, payments, corrections, and correspondence.
• Ensure compliance with HIPAA and all applicable billing and insurance regulations.

Reporting & Month-End Support

• Support month-end closing processes by assisting with AR reporting, aging review, and financial summaries.

Collaboration & Process Improvement

• Collaborate with clinical and administrative teams to verify coding, documentation, and insurance details to reduce claim rejections.
• Participate in process improvement efforts to streamline workflows and enhance reimbursement efficiency.

Additional Responsibilities

• Perform other duties as assigned.

Qualifications

Education

• High school diploma or GED required, associate or bachelor's degree in accounting, finance, business administration, or a related field preferred.

Experience

• 13 years of experience in accounts receivable, medical billing, insurance claims processing, or a similar office/finance role.
• Experience working with insurance payers, claim submission processes, and reimbursement guidelines are strongly preferred.
• Familiarity with electronic health records (EHR), practice management systems, or billing software.
• Dental or medical billing experience (if relevant to your setting) is a plus.

Performance Requirements

• Strong knowledge of accounts receivable practices, payment posting, aging reports, and denial management.
• Understanding of CPT, CDT, ICD-10 codes, and insurance terminology (if medical/dental setting).
• Excellent attention to detail and accuracy in data entry and financial reconciliation.
• Strong analytical and problem-solving skills, especially when reviewing discrepancies or denial trends.
• Ability to communicate professionally with patients, insurance representatives, and internal team members.
• Proficiency with Microsoft Office Suite, especially Excel, and comfort learning new software systems.
• Ability to prioritize tasks, manage time effectively, and work in a fast-paced, deadline-driven environment.
• Strong organizational skills with the ability to maintain accurate and confidential records.
• Ability to work independently and collaboratively as part of a team.
• Knowledge of HIPAA regulations and a commitment to maintaining patient confidentiality.
• Willingness to participate in ongoing training and adapt to changing policies, procedures, and payer requirements.

What we do for you:

• We offer Medical, Dental, and Vision Insurance plans to our full-time employees.
• Two out of the three medical plans offered include Health Savings Account (HSA) eligibility.
• Company-paid Life, AD&D and Long-Term Disability coverage.
• Additional Voluntary Life and AD&D Insurance for you and your family!
• Voluntary Short-Term Disability Insurance available to you as well
• Dependent Care Flexible Spending Account (FSA) offered.
• Immediately begin saving for retirement through our 401(k) starting with very first paycheck!
• Employer 401(k) contribution and Profit Sharing after six months of employment
• PTO and 8 Paid holidays for fulltime employees!
• Pay Range: Starting $25.00 to $29.00 per hour based on experience

The above statements are intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. OPS's management reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.