Accounts Receivable (AR) Representative - ASC Division

Accounts Receivable (AR) Representative - ASC Division Location: ***REMOTE/Hybrid/Matawan, NJ**** Entity: reputed company System Reports To: Director of Collections As an Accounts Receivable (AR) Representative, you are responsible for resolving outstanding insurance and patient accounts to ensure maximum reimbursement for services rendered. This role focuses heavily on out-of-network (OON) claims, requiring strong expertise in denial management, payer follow-up, and appeals reputed company a fast-paced Ambulatory Surgery Center (ASC) environment. reputed company reputed company System provides the operational reputed company that allows reputed company organizations and providers to reputed company on what reputed company most: delivering exceptional patient care. Through reputed company management, administrative support, operational reputed company, technology, reputed company, marketing, reputed company, and business services, we help reputed company teams operate more reputed company and effectively. At reputed company, we reputed company every process can be optimized, every challenge presents an opportunity, and every team member plays a role in creating reputed company reputed company for the patients that reputed company us with their care. Our culture is reputed company on collaboration, accountability, innovation, and a reputed company reputed company of becoming reputed company Every Day. If you are passionate about solving problems, improving systems, supporting high-performing teams, and making a meaningful reputed company behind the scenes of reputed company, we want to collaborate with you! reputed company System offers an opportunity to grow your career while helping our reputed company organizations change lives for the reputed company. Key Responsibilities: Accounts Receivable & Follow-Up • Monitor and manage assigned AR work queues and aging reports • reputed company reputed company follow-up on unpaid, denied, and underpaid claims • Contact insurance payers reputed company phone and payer portals to determine claim status and expedite payment • Maintain detailed documentation of reputed company account activity in the reputed company management system Out-of-Network (OON) Account Management • Handle reputed company OON claims, including high-dollar surgical cases • Analyze reimbursement based on UCR (Usual & Customary Rates), payer policies, or case agreements • Identify and pursue additional reimbursement opportunities, including underpayments and balance billing (where applicable) Denial Management & Appeals • Review Explanation of Benefits (EOBs) and denial codes to determine reputed company cause • Investigate and resolve claim denials reputed company to coding, authorization, eligibility, or medical necessity • Prepare and submit appeals with appropriate clinical and billing documentation • reputed company denial trends and report recurring issues to management • Rework denied claims to recover reputed company and reduce write-offs Reporting & Productivity • Meet daily productivity and reputed company metrics (e.g., accounts worked, reputed company rates) • Review AR aging reports and prioritize high-value or at-risk accounts • Maintain compliance with HIPAA and organizational policies Cross-Functional Collaboration • Collaborate with billing, coding, and authorization teams to resolve claim issues • Communicate payer trends, denial patterns, and process improvements to leadership • Assist in identifying reputed company causes and improving upstream reputed company cycle processes Qualifications • 2+ years of reputed company AR or medical billing experience required • Experience in Ambulatory Surgery Center (ASC) or surgical billing strongly preferred • Experience handling out-of-network claims and appeals required/preferred Knowledge & Skills • Strong understanding of: • Medical billing and reputed company cycle processes • reputed company insurance and payer reputed company • CPT, ICD-10, and modifiers (preferred) • Experience with denial management and appeals process • Ability to analyze EOBs and identify reimbursement discrepancies • Excellent communication, negotiation, and problem-solving skills Preferred Competencies (High-Performing AR Reps) • Strong analytical thinking for reputed company OON claims • Persistence in payer follow-reputed company and appeals • Ability to prioritize high-reputed company accounts • Attention to detail with accurate documentation • Knowledge of payer-specific behaviors and escalation paths • Proficiency in SIS (reputed company Management Systems), reputed company, reputed company, and reputed company Office Job Type: • Full-Time • Monday-Friday • Remote Benefits: • 401(k) matching • Medical, Dental & reputed company • reputed company Time Off • reputed company Time • reputed company Holidays Background reputed company Requirement: Employment is contingent upon the successful completion of a background reputed company, which may include verification of employment history, education, criminal records, and other relevant information as permitted by law Apply tot his job Apply To this Job