A/R Specialist (Temp‑to‑Hire)

Our client is seeking four experienced Accounts Receivable (A/R) Specialists to support the reduction of a commercial A/R backlog across our surgical hospital portfolio. These roles are temp‑to‑hire, with strong potential for full‑time conversion based on performance and cash‑collection results.

Pay Rate: $30/hr - $33/hr

About the Role

The A/R Specialist will manage both backlog claims and an ongoing assigned inventory. This position requires deep expertise in facility billing, orthopedic and spine claims, and a proactive, ownership‑driven approach to payer follow‑up. Successful candidates will be skilled at navigating payer policies, resolving denials, and accelerating reimbursement.

Key Responsibilities

• Investigate and analyze claims by reviewing EOBs, provider notes, payer policies, and medical necessity guidelines.

• Research denied claims at both the claim and line‑item level, identifying root causes and required corrective actions.

• Perform root cause analysis using CARC/RARC codes to identify issues related to coding (CPT/ICD‑10/modifiers), medical necessity, authorizations, documentation, timely filing, and credentialing.

• Collaborate with billing vendors to communicate denial insights, documentation needs, and next steps for corrected claims or appeals.

• Track appeal outcomes and claim statuses using vendor workflows, A/R aging reports, and payer responses to ensure timely resolution.

• Identify denial trends across service lines and recommend process improvements or training to reduce future denials.

• Partner with cross‑functional RCM teams to address documentation or coding gaps and implement preventive measures.

• Maintain accurate documentation of claim actions, denial codes, tasks, and outcomes; prepare reports for leadership on trends and recovery performance.

• Ensure compliance with HIPAA, payer regulations, and internal audit standards.

Required Qualifications

• 3–5 years of medical A/R, denial management, or revenue cycle experience, preferably in spine, orthopedics, ENT, or pain management.

• Facility claim experience (UB‑04 / 837I) required.

• Orthopedic experience required; spine experience strongly preferred.

• Demonstrated ability to review eligibility, coding (CPT, ICD‑10, HCPCS), modifiers, medical necessity, and authorization requirements.

• Strong understanding of CARC/RARC denial codes and payer reimbursement methodologies.

• Experience analyzing aging A/R, resolving underpayments, and advocating for provider reimbursement.

• Proficiency with denial/claim management systems, EMRs, spreadsheets, and payer portals.

Skills & Competencies

• Excellent verbal and written communication skills.

• Strong interpersonal and customer service abilities.

• Highly organized with exceptional attention to detail.

• Effective time management and ability to meet deadlines.

• Strong analytical and problem‑solving skills.

• Ability to work in a fast‑paced, high‑volume environment.

• Proficiency in Microsoft Office Suite.

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