Note: The job is a remote job and is open to candidates in USA. CapitexAI is a company focused on healthcare billing operations, and they are seeking an Accounts Receivable Follow-Up Manager. The role involves overseeing payer collections and claim resolution workflows while evaluating automation tools to enhance revenue recovery in complex multi-payer environments.
Responsibilities
- Oversee end-to-end A/R follow-up operations across commercial, Medicare, Medicaid, and managed care payers, driving timely resolution of outstanding and aging claims
- Manage claim status follow-up workflows via EDI 276/277 transactions, payer portals, and direct phone resolution, maintaining throughput across high-volume queues
- Prioritize A/R queues by aging bucket, payer mix, and dollar value to maximize collection rates and minimize write-offs
- Identify and resolve claim payment discrepancies, underpayments, and payer processing errors through structured escalation and payer correspondence
- Evaluate automation-generated A/R recommendations, claim status outputs, and payer correspondence drafts for clinical accuracy, payer compliance, and operational effectiveness
- Monitor KPIs including days in A/R, aging distribution, collection rates, and write-off rates, delivering performance insights that inform follow-up strategy
Skills
- Demonstrated management experience in A/R follow-up, payer collections, or revenue cycle operations within healthcare billing environments
- Deep command of EDI 276/277 transaction workflows and payer-specific collections processes across government and commercial payer types
- Thorough knowledge of Medicare, Medicaid, and managed care claims processing rules, payment timelines, and timely filing requirements
- Proven ability to manage and prioritize high-volume multi-payer A/R queues with measurable impact on revenue recovery metrics
- Proficiency with enterprise billing systems and A/R management platforms
- Working knowledge of FDCPA, HIPAA, and payer-specific compliance requirements governing follow-up activity
- CRCR, CPC, or CHFP certification, or equivalent credentialing in revenue cycle management
- Background in multi-payer follow-up within hospital or physician group settings, with experience presenting A/R reduction plans to senior leadership
- Familiarity with RCM technology platforms featuring automated follow-up capabilities and comfort structuring evaluative feedback on system-generated outputs
Benefits
- $75/hr | Flexible | Remote
Company Overview