Job Description
Job Description
Medix is hiring on behalf of a nationally recognized healthcare system for an experienced Managed Medicare AR Follow-Up Specialist to support physician billing and complex payer resolution efforts. This role is ideal for someone who enjoys researching challenging accounts, working complex denials, and navigating Managed Medicare payer guidelines.
Schedule & Work Environment
- Full-Time | Monday-Friday
- Schedule: 8:00 AM - 5:00 PM
- Training will be onsite for the first 3-4 weeks
- After training: Hybrid schedule with 1 onsite day per week (Wednesdays) and the remainder remote
Position Overview
This position is responsible for collecting and resolving outstanding Managed Medicare accounts receivable for a large physician group. The ideal candidate will have strong insurance follow-up experience, deep knowledge of Medicare Advantage/Managed Medicare payers, and a proven ability to resolve complex claims and overturn denials.
Candidates must be highly analytical, organized, and comfortable working in a fast-paced, high-volume environment while maintaining strong quality and productivity standards.
Responsibilities
Claims Follow-Up & Denial Resolution
- Perform follow-up on outstanding insurance claims with Managed Medicare payers
- Investigate claim denials, underpayments, rejections, and delayed payments
- Research complex accounts and identify missing documentation or billing discrepancies
- Prepare and submit reconsiderations and appeals
- Bring claims to full resolution through proactive follow-up efforts
- Prioritize accounts based on payer guidelines and aging reports
- Accurately document all account activity and follow-up efforts within EPIC
Payment Posting & Reconciliation
- Verify and post payments accurately
- Reconcile patient accounts and identify discrepancies
- Process adjustments, refunds, and write-offs as needed
- Research and resolve payment posting issues
Communication & Collaboration
- Communicate professionally with insurance representatives, patients, and internal departments
- Collaborate with billing, medical records, and patient access teams to resolve account issues
- Respond to inquiries in a timely and professional manner
Compliance & Reporting
- Maintain accurate account documentation and collection records
- Participate in monthly quality assessments
- Follow departmental tip sheets and payer guidelines
- Ensure compliance with HIPAA and organizational policies
Required Qualifications
- Minimum 2 years of physician billing experience
- Minimum 2 years of EPIC experience
- Strong insurance follow-up experience involving denials and rejections
- Proven success overturning denials and resolving complex claims
- Experience preparing appeals and reconsiderations
- Strong understanding of Medicare and Managed Medicare/Medicare Advantage payers
- Excellent analytical and problem-solving skills
- Ability to research accounts thoroughly and identify root-cause issues
Preferred Qualifications
- Ability to multitask in a fast-paced, high-volume environment
- Strong Microsoft Office skills, especially Excel
- Experience with 10-key and basic math functions
Performance Expectations
- Productivity standard: 45 accounts per day
- Quality standard: 90% or higher accuracy
- Quality metrics include accurate notation and timely follow-through
What Makes This Opportunity Stand Out
- Hybrid flexibility after training
- Opportunity to work for a top nationally recognized health system
- Strong team environment with structured onboarding and ongoing quality support
- Ideal role for candidates who enjoy solving challenging payer and denial issues
If you have strong Managed Medicare experience and enjoy working complex AR accounts from denial through resolution, we'd love to connect with you.
For California Applicants:
We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).
This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
Company DescriptionHere at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.
Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?
Company Description
Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.\r\n\r\nOur commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?