Accounts Receivable Escalations Specialist at Monmouth Gastroenterology a division of Allied Digestive Health

West Long Branch, New Jersey, United States -

Full Time

Start Date

Immediate

Expiry Date

05 Jul, 26

Salary

25.0

Posted On

07 Apr, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Accounts Receivable, Denial Resolution, Revenue Cycle Management, Payer Outreach, Negotiation, Critical Thinking, Problem Solving, Analytical Skills, Investigative Skills, Communication Skills, Interpersonal Skills, Detail Oriented, Reimbursement Methodologies, Appeals, Financial Impact Awareness

Industry

Medical Practices

Description

SUMMARY: THE ACCOUNTS RECEIVABLE ESCALATIONS SPECIALIST IS RESPONSIBLE FOR MANAGING COMPLEX, AGED, HIGH-RISK, AND HIGH-DOLLAR ACCOUNTS REQUIRING ADVANCED INTERVENTION TO DRIVE PAYMENT RESOLUTION. THIS ROLE SERVES AS THE FINAL OPERATIONAL ESCALATION LAYER WITHIN THE REVENUE CYCLE MANAGEMENT (RCM) FUNCTION, FOCUSING ON REMOVING PAYMENT BARRIERS, ACCELERATING CASH RECOVERY, AND PREVENTING LONG-TERM AGING EXPOSURE. THE ESCALATIONS SPECIALIST ENSURES CLAIMS MOVE FORWARD CLEANLY THROUGH THE REVENUE CYCLE TOWARD FINANCIAL RESOLUTION WHILE IDENTIFYING SYSTEMIC BREAKDOWNS IMPACTING REIMBURSEMENT PERFORMANCE. ESSENTIAL RESPONSIBILITIES: The responsibilities of Accounts Receivable Escalations Specialist will include: * Manage accounts aged 70+ days or identified as payment risk. * Resolve complex payer issues requiring advanced research. * Financial impact awareness * Prioritize high-balance accounts impacting cash flow. * Perform high-level payer outreach and escalation conversations. * Coordinate resolution for stalled, rejected, or repeatedly denied claims. * Drive accounts to final disposition (paid, adjusted, or escalated legally). * Lead second-level and executive appeals. * Execute targeted recovery strategies on aged inventory. * Identify recurring revenue cycle breakdowns and provide structured feedback. * May be required to conduct and/or participate in training sessions at the office level. * Participates in special projects as assigned. * Any other duties assigned. Essential Skills: The Accounts Receivable Escalations Specialist must be extremely detail oriented. The Accounts Receivable Escalations Specialist must be able to comprehend all issues and be able to articulate those issues to any involved person(s) needed to assist in their complete resolution. He/she must also possess: * Revenue ownership mindset and Escalation judgment * Problem solving and organizational skills with Critical thinking. * Reliability, Accuracy and Efficiency when dealing with patients or third-party payors. * Persistence and negotiation ability * Operational accountability * Ability to work independently with minimal supervision and be result oriented. * Ability to use good judgments in highly emotional and demanding situations. * Ability to react to frequent changes in duties and volume of work. * Excellent oral and written communication skills. * Effective interpersonal skills, including the ability to promote teamwork. * Strong problem-solving skills. * Ability to ensure a high level of customer satisfaction including employees, patients, physicians, and external stakeholders. * Maintains confidentiality of sensitive information EDUCATION AND EXPERIENCE REQUIRED: * High School Diploma * 3+ years of healthcare Accounts Receivable experience * Advanced payer follow-up and denial resolution expertise * Knowledge of reimbursement methodologies * Strong analytical and investigative skills * Ability to manage complex account portfolios Preferred Qualifications * Escalations or complex A/R specialization * Multi-specialty or MSO experience * Appeals and payer negotiation experience * Experience with Athena, Epic, eClinicalWorks, or similar PM systems TRAVEL MINIMAL This is a full-time position, and hours of work 8:30am-5:00pm and days are Monday through Friday

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Responsibilities

The specialist manages complex, high-risk, and high-dollar accounts to drive payment resolution and accelerate cash recovery. They also identify systemic revenue cycle breakdowns and lead second-level and executive appeals.