We are seeking an experienced
Spanish Bilingual A/R Follow-Up Specialist to join our growing Revenue Cycle team. This role is responsible for managing outstanding insurance accounts, resolving denied or underpaid claims, and ensuring timely reimbursement from commercial and government payers.
The ideal candidate has extensive experience in
medical accounts receivable (A/R) follow-up, thrives in a high-volume environment, and consistently meets productivity goals. Experience with
AdvancedMD EMR is highly preferred, while experience supporting
Orthopedics, Pain Management, Podiatry, or Laboratory/Diagnostic Billing is a strong advantage.
Key Responsibilities
- Perform accounts receivable (A/R) follow-up on outstanding insurance claims to maximize reimbursement and reduce aging balances.
- Meet or exceed the daily productivity goal of 65 accounts per day while maintaining a high level of accuracy and quality.
- Review, investigate, and resolve unpaid, denied, or underpaid insurance claims.
- Handle claims involving:
- Modifier 25 documentation requirements
- Evaluation and Management (E/M) level validation
- Medical records submission requests
- Laboratory billing claim issues and documentation requirements
- Submit medical records, clinical documentation, and supporting information to insurance payers as requested.
- Communicate with insurance companies through phone calls and payer portals to determine claim status and resolve reimbursement issues.
- Accurately document all follow-up activities, claim updates, and payer communications within the billing system.
- Identify denial trends, recurring payer issues, and workflow opportunities, escalating concerns when appropriate.
- Collaborate with coding, billing, and front-end teams to prevent future denials and improve reimbursement outcomes.
- Maintain compliance with HIPAA, payer regulations, and organizational billing policies.
Qualifications
- Spanish-English bilingual proficiency (spoken and written) is required.
- Minimum of 2 years of medical billing experience with a strong focus on Accounts Receivable (A/R) Follow-Up.
- Proven ability to manage high-volume workloads while consistently achieving productivity goals of 65 or more accounts per day.
- Hands-on experience with insurance claim follow-up, denial management, and reimbursement resolution.
- Experience with laboratory billing, including laboratory claim follow-up and payer documentation requirements.
- Strong understanding of:
- Modifier 25 usage and documentation
- Evaluation & Management (E/M) coding levels
- Medical necessity documentation
- Laboratory billing workflows
- Documentation-based claim resolution
- Experience submitting medical records and supporting documentation to insurance payers.
- Familiarity with payer portals and insurance follow-up processes.
- Strong knowledge of commercial insurance, Medicare, Medicaid, and payer reimbursement guidelines.
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.
