Note: The job is a remote job and is open to candidates in USA. Steadfast Health provides patient-centered substance use disorder care and is seeking an Accounts Receivable Representative to support its revenue cycle operations. The role follows up on outstanding insurance accounts receivable, investigates unpaid and underpaid claims, resolves denials and payment issues, and drives claims to final resolution.
Responsibilities
- Perform consistent follow-up on outstanding insurance claims to ensure timely and accurate reimbursement
- Work assigned accounts receivable and payer worklists based on established RCM priorities and aging guidelines
- Research unpaid, underpaid, rejected, and denied claims to determine the appropriate resolution
- Contact insurance payers through payer portals, telephone, and other available resources to obtain claim status and resolve outstanding balances
- Review claim status, remittance information, Explanation of Benefits (EOBs), and Electronic Remittance Advice (ERA) to identify payment or processing issues
- Correct claim errors and submit corrected claims, reconsiderations, and appeals when appropriate
- Identify and resolve issues related to eligibility, authorization, coding, billing requirements, timely filing, coordination of benefits, medical necessity, and payer-specific requirements
- Follow up on denied claims and take appropriate action to obtain payment or achieve accurate final claim disposition
- Identify underpayments and discrepancies between expected and actual reimbursement and escalate potential payer or contractual issues as appropriate
- Maintain accurate and detailed account documentation of all follow-up activities, payer communications, actions taken, and next steps
- Prioritize accounts based on aging, balance, timely filing requirements, payer deadlines, and departmental priorities
- Identify recurring payer trends, denial patterns, workflow issues, and other barriers to reimbursement and escalate findings to RCM leadership
- Collaborate with coding, intake, clinical operations, and other internal teams as needed to resolve claim and reimbursement issues
- Support achievement of departmental performance goals related to Days in AR, Net Collection Rate, denial rate, timely filing, and overall AR reduction
- Follow organizational policies and procedures and maintain compliance with HIPAA and applicable payer and regulatory requirements
- Assist with special AR projects, account clean-up initiatives, payer research, and other revenue cycle activities as needed
- Perform other RCM team tasks and responsibilities as assigned
Skills
- 3–5 years of healthcare accounts receivable, insurance claim follow-up, and claim resolution experience
- Demonstrated experience independently researching and resolving unpaid, underpaid, rejected, and denied insurance claims
- Strong knowledge of the healthcare revenue cycle and insurance reimbursement processes
- Experience working with commercial and government payers
- Ability to interpret EOBs, ERAs, claim status information, denial messages, and payer correspondence
- Experience using payer portals and communicating directly with insurance companies to resolve claims
- Strong attention to detail, organizational skills, and ability to manage a high-volume AR workload
- Ability to identify trends and escalate systemic reimbursement or payer issues appropriately
- Strong written and verbal communication skills
- Ability to work independently while collaborating effectively within an RCM team
- Behavioral health and/or substance use disorder billing and AR experience
- Experience with Medicaid and managed Medicaid claims
- Experience with Medicare and commercial insurance claims
- Experience with athenahealth
- Familiarity with Availity and other payer portals
- Experience working in a multi-state healthcare organization
- Experience with denial management, appeals, corrected claims, and complex claim resolution
- Strong analytical and problem-solving skills with a focus on claim resolution and reimbursement
- Ability to independently manage AR worklists, prioritize accounts, and drive claims through final resolution
- Detail-oriented with the ability to identify denial trends, payer issues, and opportunities for process improvement
- Strong communication and collaboration skills with payers, RCM team members, and operational partners
- Experience with behavioral health and/or substance use disorder (SUD) claims is strongly preferred
- Reside in FL, GA, NC, NY, OH, PA, TN, or TX
Benefits
- Comprehensive medical, dental, and vision insurance for you and your family.
- 401(k) match up to 5% to help you invest in your future.
- 100% employer-paid short-term and long-term disability insurance, plus employer-sponsored life insurance for added peace of mind.
- Generous PTO, floating paid holidays, and paid volunteer days
- Re-Fuel Days: Take four paid days each year to recharge — for mental health, rest, or continuing education.
- Employee Assistance Program (EAP): Free, confidential access to therapy sessions, legal guidance, financial resources, and health coaching.
- SoFi student loan interest rate discount, Rightway Health Concierge, 1 year free pet Telehealth through Pawp, and Perkspot Discount Marketplace
- A collaborative team that listens to and uplifts frontline voices, fostering belonging and trust in every interaction.
Company Overview