Accounts Receivable Specialist

Role Overview

• Manage assigned insurance accounts receivable to ensure timely reimbursement and reduce aging balances.
• Follow up with insurance payers on outstanding claims, underpayments, denials, and payment discrepancies.
• Investigate and resolve claim denials by submitting corrected claims, appeals, reconsiderations, and supporting documentation in accordance with payer requirements.
• Review claim edits and rejections to ensure accurate resubmission and minimize future denials.
• Accurately post insurance payments, adjustments, and remittances into the billing system.
• Perform daily payment reconciliation by ensuring posted payments align with electronic remittance advice (ERA), explanation of benefits (EOB), bank deposits, and payment reports.
• Research and resolve unapplied cash, payment variances, overpayments, and underpayments.
• Reconcile payer payments against contracted reimbursement rates and escalate payment discrepancies as appropriate.
• Maintain accurate documentation of AR activities, payer communications, payment research, and resolution outcomes.
• Respond professionally and empathetically to patient inquiries regarding insurance claims, billing statements, payment activity, balances, and Oshi's billing model, policies, procedures, and applicable healthcare regulations.
• Maintain open communication with providers, payers, and internal stakeholders to investigate, resolve, and prevent claim and payment issues.
• Collaborate with Billing, Eligibility & Benefits, Credentialing, Finance, Clinical Operations, and other cross-functional teams to resolve reimbursement issues and improve revenue cycle performance.
• Analyze accounts receivable, payment, and denial data to identify trends, root causes, and opportunities for process improvement.
• Monitor and report on AR performance, payment posting accuracy, denial trends, aging, and other key revenue cycle metrics, providing insights and recommendations to leadership.
• Support month-end close activities, payment balancing, reporting, and audit requests.
• Identify recurring reimbursement or operational issues and recommend process improvements to improve payment accuracy, accelerate cash collections, and reduce denials.
• Ensure compliance with organizational policies, payer requirements, financial regulations, HIPAA, and healthcare billing standards while maintaining accuracy and integrity in all revenue cycle activities.

Requirements

• Bachelor's Degree in Business Administration or relevant course work.
• 2+ years of healthcare revenue cycle experience with a focus on accounts receivable, payment posting, or insurance billing.
• Knowledge of medical billing, insurance claims processing, and payer reimbursement.
• Experience resolving claim denials, underpayments, and payment discrepancies.
• Experience posting payments and reconciling ERAs, EOBs, deposits, and unapplied cash.
• Experience working successfully in a remote work environment with the ability to manage priorities independently.
• Proficiency with EMR and medical billing systems.
• Strong analytical, problem-solving, and organizational skills with excellent attention to detail.
• Excellent communication and customer service skills.
• Proficiency with Google Workspace (Sheets, Docs, Gmail) and the ability to quickly learn new systems and technology.

Benefits

• Health Benefits: Employer-sponsored medical, dental, and vision coverage
• Time Off: Unlimited PTO + 11 paid company holidays
• Retirement: Eligibility to contribute to 401(k)
• Work Style: Remote-first — work from home within our approved states
• Growth: Tailored professional development opportunities as we scale
• Life Concierge: Access to Overalls, because we know life happens