Accounts Receivable Specialist

Overview

WHO WE ARE

Aviva Health is a dynamic and mission-driven federally qualified health center (FQHC). Aviva Health provides comprehensive and compassionate healthcare services with a holistic approach to care, addressing patients' medical, behavioral health, dental, and social service needs. Join us at Aviva Health and be part of a team that is dedicated to making a difference in the lives of our patients and the community we serve.

• Monday - Friday Scheduling
• Paid Holidays
• PTO
• Comprehensive Medical, Dental, and Vision Coverage
• 403(b) Retirement with Employer Match

The Accounts Receivable Specialist position assists patients and staff with questions and concerns regarding professional billing in a prompt and courteous manner by performing account research, balance verification and patient support.

• Responsible for all activity related to collection of Self-Pay balances.
• Work with the patients, billing specialists and third-party payers to maximize collections.
• Utilize established policies and procedures to work returned mail and bankruptcy notices.
• Responsible for accurate and timely bad debt adjustments in accordance with established policies and procedures, including bad debt letters to inform patients of their status.
• Process over payments, research to confirm balances are appropriately applied and request refunds as indicated.
• Assist the billing department team with other relevant duties.
• Other duties as assigned by managerial staff.
• Manage medical accounts receivable to ensure timely and accurate reimbursement from insurance carriers, government payers, and patients.
• Submit, monitor, and follow up on insurance claims (commercial, Medicare, Medicaid) to resolution, identifying and correcting errors or denials.
• Analyze Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERA) to ensure payments are applied correctly and underpayments are identified.
• Research and resolve denied, rejected, or underpaid claims, including preparing and submitting appeals with supporting documentation.
• Post payments and adjustments accurately to patient accounts in the practice management or electronic health record (EHR) system.
• Maintain compliance with payer rules, billing regulations, and organizational policies, including HIPAA and other privacy standards.
• Communicate with insurance companies via phone, portals, and written correspondence to obtain claim status and resolve discrepancies.
• Collaborate with front desk, clinical staff, and coding/billing teams to resolve documentation, coding, or eligibility issues affecting reimbursement.
• Monitor aging reports and key A/R metrics, prioritizing follow-up on high-dollar and time-sensitive accounts.
• Educate patients as needed regarding insurance balances, payment responsibility, and billing questions in a professional and confidential manner.
• Identify trends in denials or payment delays and escalate systemic issues to leadership with recommendations for improvement.
• Maintain accurate documentation of all follow-up actions, communications, and resolutions within the billing system.
• Support audits and reporting requests related to accounts receivable, payer activity, and financial performance.

• High school diploma or GED.
• Minimum of two years of experience in a medical office setting preferred.
• Experience with handling phone calls and assisting patients over the phone.
• Awareness of CPT and ICD-10 coding is preferred.
• Ability to multitask, work independently, be organized and self-motivated.
• Good typing skills and attention to detail required.
• Good communication and interpersonal skills.

Must be able to perform the following physical requirements:

• Remain in a stationary position frequently throughout the day while performing duties.
• Move or traverse occasionally throughout the day throughout the worksite.
• Operate equipment frequently throughout the day: computer, phone, printer, standard office equipment.
• Ability to communicate information and ideas clearly and accurately so others will understand; ability to interact with patients and staff clearly.
• Work on-site indoors in a heat-controlled environment 100% of the…