Insurance Accounts Receivable Specialist

Job Summary

The Insurance AR Specialist Level I - AR Position supports the Ancillary Billing department by managing assigned accounts receivable worklists, reviewing billing exceptions, resolving outstanding balances, and supporting timely follow-up for mammography-related accounts, AHCCCS adjustments, self-pay balances, non-covered documentation, IMQM messaging, and claims that have not yet been billed. This role requires strong attention to detail, consistent worklist management, clear documentation, and timely escalation of barriers that impact billing, reimbursement, or account resolution.

Duties and Responsibilities

Core responsibilities include the following:

•  Monitor and work assigned AR queues and billing worklists in accordance with departmental priorities and established workflows.
•  Review mammography AR worklists, research account status, document follow-up activity, and identify accounts requiring correction, escalation, or additional documentation.
•  Identify AHCCCS-related adjustment opportunities and route or process adjustments according to departmental guidance.
•  Review claims or encounters appearing on never-billed worklists, determine the reason billing has not occurred, and coordinate the next step needed to move the account forward.
•  Support non-covered service workflows by reviewing accounts that may require patient forms, documentation, or additional billing review before resolution.
•  Monitor and respond to IMQM messages related to billing or AR follow-up, ensuring timely documentation and appropriate communication with internal stakeholders.
•  Assist with self-pay AR follow-up, including reviewing outstanding balances, identifying account issues, and supporting resolution according to approved processes.
•  Participate in over-90-day AR training and apply learned workflows to accounts requiring aging review, escalation, or specialized follow-up.
•  Maintain accurate, concise, and professional notes within applicable systems to support account history and continuity of follow-up.
•  Escalate complex accounts, payer issues, system concerns, documentation gaps, or workflow barriers to the appropriate leader or subject matter expert.
•  Communicate professionally with internal team members, branch staff, and other departments as needed to support AR resolution and billing accuracy.
•  Protect patient and organizational information by following confidentiality, HIPAA, and company compliance expectations.

Job Description

•  Experience in medical billing, accounts receivable, revenue cycle, or a related healthcare administrative role preferred.
•  Ability to review account details, identify discrepancies, and follow documented procedures with accuracy and consistency.
•  Working knowledge of insurance billing concepts, payer follow-up, adjustment workflows, and patient balance review preferred.
•  Ability to learn and navigate billing systems, worklists, payer portals, Microsoft Outlook, Teams, and other department tools.
•  Strong written and verbal communication skills with the ability to document clearly and professionally.
•  Strong organizational skills and the ability to manage multiple worklists, priorities, and follow-up tasks.
•  Ability to maintain confidentiality and follow HIPAA, compliance, and company policy requirements.
•  Willingness to participate in ongoing training and adapt to updated workflows, payer requirements, and departmental priorities.

Physical Requirements

This position primarily performs administrative and computer-based work in an office or remote-office environment. The role requires the ability to remain seated for extended periods, use a computer and phone, communicate clearly, and perform routine office tasks.

Work Environment

Work is performed in a professional office, clinic administrative, or approved remote-office setting. The role requires frequent computer use, regular communication through email, Teams, phone, and billing systems, and collaboration with billing, ancillary, branch, and operational stakeholders. The employee is expected to maintain professionalism, confidentiality, and accuracy while working independently and as part of a team.

Physical Demands

•  Prolonged periods of sitting at a desk and working on a computer.
•  Frequent use of hands and fingers for typing, operating office equipment, and using technology systems.
•  Ability to communicate effectively, including speaking, hearing, and exchanging information in person, virtually, and via phone.
•  Occasional standing, walking, bending, or reaching within office or clinical environments.
•  Ability to lift and carry light items, typically up to 15-25 pounds, such as laptops, documents, or office materials.