Accounts Receivable Specialist

Description

At Terra Fertility, we are reimagining fertility care. Our mission is to make reproductive health more accessible and equitable through transparent pricing, innovative technology, and comprehensive patient education. We believe that everyone—regardless of background, language, or identity—should feel informed, empowered, and supported on their fertility journey.

Position Overview

Terra Fertility is seeking an experienced Accounts Receivable Specialist to join our growing team.

We are looking for an individual with a strong background in medical billing and insurance accounts receivable who can independently manage complex claims, resolve denials and underpayments, and ensure timely and accurate reimbursement.

The ideal candidate brings demonstrated success in payer follow-up, appeals, and reimbursement recovery, along with strong analytical skills and a proactive approach to problem-solving. Direct experience in infertility and assisted reproductive technology (ART) billing is strongly preferred. Candidates with extensive medical billing and denial management experience who can learn fertility-specific requirements are also encouraged to apply.

This position reports to the AR & Billing Lead and works closely with billing, patient financial coordinators, prior authorization staff, clinical teams, practice leadership, and insurance payers.

Key Responsibilities

Accounts Receivable & Collections

• Independently manage an assigned portfolio of insurance accounts receivable, including complex and high-value balances.
• Follow up on unpaid, rejected, denied, and underpaid claims to secure timely reimbursement.
• Review insurance aging reports and prioritize claims based on aging, dollar amount, denial status, and filing deadlines.
• Maintain accurate, detailed documentation of follow-up activities, payer responses, and next steps within the practice management system.
• Consistently meet established productivity, collection, accuracy, and AR reduction goals.

Denials Management & Appeals

• Investigate claim denials and payment discrepancies to determine the appropriate steps for resolution.
• Prepare and submit corrected claims, reconsiderations, appeals, and supporting documentation within payer deadlines.
• Resolve issues involving authorization, medical necessity, timely filing, coordination of benefits, and bundled services.
• Coordinate billing corrections and documentation requests with billing, financial counseling, prior authorization, and clinical teams.
• Track appeals through final resolution and escalate unresolved claims with clear supporting documentation.

AR Reporting & Account Review

• Review EOBs, ERAs, payer contracts, and reimbursement schedules to evaluate payment accuracy.
• Identify underpayments, incorrect adjustments, and outstanding reimbursement opportunities.
• Monitor payer takebacks, recoupments, and other payment discrepancies.
• Assist with AR reconciliation, routine reports, and tracking spreadsheets.
• Recommend adjustments or write-offs for review according to practice policy.

Claims & Payer Follow-Up

• Research payer-specific billing, authorization, and reimbursement requirements, including those related to fertility services.
• Use payer portals, clearinghouses, and direct payer communication to resolve outstanding claims.
• Maintain working knowledge of timely filing limits, appeal procedures, and payer-specific policies.
• Communicate professionally with insurance representatives, internal teams, and patients as needed.

Process Improvement

• Identify recurring denial trends and payment barriers and communicate findings to the AR & Billing Lead.
• Recommend improvements to billing workflows, claim submission, and AR follow-up.
• Assist with maintaining AR procedures and payer reference materials.
• Collaborate with internal teams to reduce preventable denials and improve reimbursement.

 Compensation & Benefits

• $30–$40 per hour, depending on experience and qualifications
• Medical, dental, and vision insurance
• 401(k) with employer match
• Paid time off and paid holidays
• Professional development opportunities

Employment Details

• Full-time (40 hours per week)
• On-site in Dedham, Massachusetts, potential hybrid in the future

Requirements

• Minimum 3 years of medical billing, insurance accounts receivable, or revenue cycle experience, including substantial hands-on insurance AR follow-up.
• Demonstrated experience independently resolving denials, submitting appeals and reconsiderations, and recovering outstanding reimbursement.
• Strong understanding of insurance benefits, prior authorization requirements, medical necessity guidelines, and payer-specific billing policies.
• Ability to interpret EOBs, ERAs, payer contracts, and reimbursement schedules.
• Working knowledge of CPT, HCPCS, ICD-10 diagnosis codes, and appropriate modifiers.
• Experience working with commercial insurance carriers such as Blue Cross Blue Shield, Harvard Pilgrim, Tufts Health Plan, UnitedHealthcare, Aetna, and Cigna.
• Experience reviewing insurance aging reports and prioritizing outstanding claims.
• Proficiency with EMR and practice management systems, clearinghouses, and insurance payer portals.
• Proficiency in Excel and/or Google Sheets, including sorting, filtering, and maintaining tracking spreadsheets.
• Strong analytical, organizational, problem-solving, and communication skills.
• Ability to independently manage a high-volume AR workload and consistently meet departmental expectations.
• Knowledge of HIPAA regulations and patient confidentiality requirements.
• High school diploma or equivalent.

Preferred Qualifications

• Associate or bachelor’s degree in Business, Healthcare Administration, Finance, Accounting, Analytics, or a related field.
• Five or more years of relevant medical billing and insurance AR experience.
• Direct experience in infertility, reproductive endocrinology, ART, or women’s health billing.
• Understanding of billing for IVF, IUI, frozen embryo transfers, diagnostic fertility testing, and reproductive surgical procedures.
• Knowledge of fertility-specific S-codes, global fertility packages, bundled services, and payer-specific reimbursement requirements.
• Familiarity with fertility benefit administrators and programs, including WINFertility, Maven, and Carrot.
• Experience resolving complex infertility denials involving authorization, medical necessity, timely filing, and bundled services.
• Understanding of fertility-related laboratory, embryology, cryopreservation, and storage billing.
• Experience reviewing payer contracts and identifying underpayments.
• Certified Professional Biller (CPB), Certified Professional Coder (CPC), or another relevant professional certification.
• Familiarity with Azalea or similar healthcare billing systems.