Medical Billing & AR Specialist

The Medical Billing & AR Specialist will manage and support the clinic’s end-to-end medical billing and Revenue Cycle Management (RCM) processes.

The role will focus on claims processing, EOB review, payment posting, insurance follow-ups, denial and rejection management, and accounts receivable (AR) management. The specialist will monitor outstanding accounts, follow up on unpaid claims, identify payment issues, and help ensure timely and accurate reimbursement.

The ideal candidate has strong experience in U.S. medical billing, insurance claims, EOBs, payment posting, and AR follow-up, with eClinical

Works (eCW) experience preferred.

Key Responsibilities

Manage end-to-end medical billing and RCM activities.

Submit and monitor U.S. healthcare insurance claims.

Review claims for completeness and accuracy before submission.

Monitor outstanding and aging accounts receivable, particularly 90+ and 120+ day AR.

Follow up on unpaid, delayed, denied, and underpaid insurance claims.

Review EOBs (Explanation of Benefits) and identify payment, adjustment, denial, and patient responsibility issues.

Post insurance payments, adjustments, and patient balances accurately and on time.

Reconcile payments and account balances.

Identify and resolve claim denials, rejections, and billing issues.

Submit and follow up on appeals when needed.

Contact insurance payers through payer portals, phone, or other available channels to check claim status and resolve issues.

Maintain accurate and updated account and claim information.

Monitor AR aging and take appropriate action to reduce outstanding balances.

Track claims, payments, denials, and unresolved accounts.

Prepare regular reports on AR aging, claims status, payments, denials, and collections.

Complete assigned billing, payment posting, and follow-up tasks within agreed SLAs.

Maintain confidentiality when handling patient and healthcare information.

Identify recurring billing and RCM issues and recommend process improvements.

Work independently while coordinating with the clinic team and other relevant stakeholders.

• Required Skills & Competencies
• Strong knowledge of U.S. medical billing and Revenue Cycle Management (RCM).
• Experience with U.S. healthcare insurance claims and payer processes.
• Strong AR management and follow-up skills.
• Experience reviewing EOBs and understanding insurance payments and adjustments.
• Experience with payment posting and account reconciliation.
• Experience handling denials, rejections, and appeals.
• Experience following up on unpaid and aging claims.
• Knowledge of insurance payer portals and claims submission platforms.
• Strong attention to detail and accuracy.
• Good communication and comprehension skills.
• Strong organization and time-management skills.
• Ability to manage multiple accounts, priorities, and deadlines.
• Ability to work independently with minimal supervision.
• Ability to handle confidential patient information appropriately.
• Experience Requirements
• 2–3 years of relevant experience in U.S. medical billing or Revenue Cycle Management (RCM).
• Experience handling U.S. healthcare claims, insurance processes, EOBs, payment posting, AR, denials, and follow-ups.
• Direct experience managing aging AR, including 90+ and 120+ day accounts.
• Experience working with insurance payer portals and claims submission platforms.
• Experience with eClinical

Works (eCW) is preferred.

• Practical experience with full-cycle medical billing and RCM processes.
• Preferred Qualifications
• Bachelor’s degree in Healthcare Administration, Health Information Management, Nursing, or a related healthcare field.
• CPB or equivalent Medical Billing certification is a plus.
• Experience using eClinical

Works (eCW).

• Strong understanding of HIPAA and healthcare data privacy.
• Strong knowledge of medical terminology.
• Willingness to undergo additional RCM/eCW training as needed.

Tools & Systems eClinical

Works (eCW)

• Insurance / Payer Portals
• Clearinghouse / Claims Submission Platforms
• Microsoft Excel / Google Sheets
• Microsoft Teams / Communication Tools

Email

ALAGA Productivity & Reporting Tools