Accounts Receivable and Case Management Specialist

About Our Client

The organization is a national, technology-driven physician enablement company that partners with medical groups, health plans, and health systems. It aims to optimize physician practices and improve patient experiences by supporting doctors in delivering high-value care through both in-person and virtual settings. The platform combines scalable operations with cloud-based technology to reduce healthcare costs, improve outcomes, and enhance the well-being of patients and providers.

About the Opportunity

The Accounts Receivable & Case Management Specialist is responsible for managing claims concerns and projects within the revenue cycle. This role ensures accurate and timely processing of claims, acting as a liaison between financial accuracy and effective communication. It contributes by resolving insurance claim denials and managing escalated inquiries to maintain accountability and support revenue cycle performance.

Responsibilities

• Manage the full cycle of Salesforce cases for revenue cycle management inquiries, ensuring documentation and resolution within Service Level Agreements (SLAs).
• Monitor Salesforce dashboards to identify trend patterns and report case resolution efficiency to leadership.
• Apply expertise in billing, accounts receivable follow-up, and denial management to resolve escalated cases efficiently.
• Make independent decisions on claim adjustments, resubmissions, and advanced resolution techniques following policies and best practices.
• Collaborate with internal teams and care center staff to streamline workflows and resolve billing issues.
• Use Trizetto to perform denial analysis and request rule or edit updates to prevent recurring errors.
• Work with practice consultants or physicians to optimize revenue cycle functionality and drive department Key Performance Indicators (KPIs).
• Perform additional duties as assigned.

Requirements

• High School Graduate.
• Minimum of 3 years’ experience in a medical billing office or equivalent claims experience.
• Advanced Microsoft Excel skills preferred (pivot tables, VLOOKUP, formulas).
• Experience with athenaHealth/athenaOne and Salesforce Case Management highly preferred.
• Strong understanding of credentialing and enrollment related to claims processing.
• Ability to understand revenue cycle drivers and resolve complex claim issues.
• Strict compliance with HIPAA rules and company policies regarding information privacy.

Pay Range and Compensation Package

• Salary range is $52,000 to $55,000 base pay, excluding bonus and benefits.
• Eligible for an annual bonus targeted at 10%.
• Base pay determination considers experience, education, and geographic location.

Equal Opportunity Statement

Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, gender, gender identity or expression, sexual orientation, or national origin.

Note

RemoteHunter is not the Employer of Record (EOR) for this role. Our purpose in this opportunity is to connect exceptional candidates with leading employers. We help job seekers worldwide discover roles that match their goals and guide them to complete their full application directly through the hiring company’s career page or ATS.

Key skills/competency

• Salesforce Case Management
• Revenue Cycle Management
• Medical Billing
• Accounts Receivable
• Denial Management
• Trizetto
• athenaHealth/athenaOne
• HIPAA Compliance
• Microsoft Excel
• KPI Optimization