We are seeking an experienced
Accounts Receivable (A/R) Specialist – Laboratory Billing to join our growing Revenue Cycle Management team. In this role, you will be responsible for managing the full insurance accounts receivable process for laboratory claims, ensuring timely reimbursement while minimizing denials and outstanding balances.
The ideal candidate has extensive experience in laboratory billing, insurance follow-up, denial management, and payer reimbursement processes. This individual is highly analytical, detail-oriented, and capable of independently managing a high-volume workload while maintaining exceptional quality standards. Experience using
CollaborativeMD (CMD) Practice Management/EMR is required.
Key Responsibilities
- Perform insurance follow-up on outstanding laboratory claims with commercial, Medicare, Medicaid, and managed care payers.
- Investigate and resolve denied, rejected, underpaid, and unpaid laboratory claims.
- Review and interpret Explanation of Benefits (EOBs), Electronic Remittance Advice (ERAs), and payer correspondence to determine appropriate actions.
- Submit corrected claims, appeals, reconsiderations, and supporting documentation to maximize reimbursement.
- Research payer policies and identify root causes of denials to reduce future claim issues.
- Verify claim status through insurance payer portals and direct communication with insurance representatives.
- Accurately document all account activity, follow-up efforts, and payer communications within CollaborativeMD.
- Work aging reports and prioritize accounts to achieve collection and productivity goals.
- Collaborate with billing, coding, credentialing, and client teams to resolve claim and reimbursement issues.
- Ensure compliance with laboratory billing regulations, payer requirements, and HIPAA guidelines.
- Identify reimbursement trends, recurring payer issues, and opportunities for process improvement.
- Maintain accuracy, productivity, and quality standards while meeting departmental performance metrics.
Qualifications
- Minimum of 3 years of Medical Accounts Receivable (A/R) experience.
- Minimum of 2 years of laboratory billing and laboratory insurance follow-up experience.
- Required hands-on experience using CollaborativeMD (CMD) Practice Management/EMR.
- Strong understanding of commercial insurance, Medicare, Medicaid, and managed care reimbursement processes.
- Experience resolving claim denials, underpayments, corrected claims, appeals, and payment research.
- Ability to analyze EOBs, ERAs, payer correspondence, and reimbursement policies.
- Excellent written and verbal communication skills.
- Strong analytical, organizational, and problem-solving abilities.
- High level of accuracy and attention to detail.
- Proficiency in Microsoft Office applications, particularly Excel.
- Experience with molecular, pathology, toxicology, or diagnostic laboratory billing.
- Familiarity with CPT, HCPCS, and ICD-10 coding related to laboratory services.
- Experience using payer portals such as Availity, Noridian, Novitas, and Medicare Administrative Contractor (MAC)websites.
- Certified Professional Biller (CPB) or equivalent billing certification is preferred.
Perks
- Permanent Work From Home
- Leave Credits
- Monetary Allowance
- Annual Bonus
- Weekly Paychecks
- Fixed Weekends Off
- Thriving Company Culture with Complete Autonomy
- Exclusive Specialized Training Programs
- Unlock Your Potential with a Highly Competitive Salary
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Who are we
BizForce is one of the fastest-growing global outsourcing companies in the world, founded in the US in Tucson, Arizona and is now operational in PH!
Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.
