AR Specialist

Job Description

REQUIREMENTS

• 2+ years in denial management or AR follow-up.
• Knowledge of payer policies, appeal timelines, and CARC/RARC codes.
• Strong analytical and written communication skills.

Preferred

• Experience with specialty care denials (especially retina).
• Familiarity with payer portals and electronic appeals.
• Familiarity with PM/EHR systems (e.g., Healthpac, NextTech, ModMed, ECW, Athena, MedInformatics, AdvancedMD).

RESPONSIBILITIES

• Analyze denial codes, EOBs, and payer correspondence.
• Determine corrective actions: corrected claim, appeal, or documentation request.
• Prepare appeal packets including clinical notes, letters, and supporting evidence.
• Categorize denials (coding, eligibility, authorization, bundling, documentation).
• Identify trends and escalate repeat issues to team leadership.
• Maintain denial logs with actions, outcomes, and recovery amounts.
• Provide weekly denial summary reports and recommendations.
• Work with coders, billers, and charge entry to correct workflows.
• Provide education on recurring denial patterns.

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