Hospital Account Receivable Specialist
Professional Physical Therapy
Summary
Under the supervision of the Manager of Patient Accounts, the Patient Accounts Specialist manages Medicare professional and institutional accounts throughout the revenue cycle. This role is responsible for insurance follow-up, denial resolution, claim corrections, appeals, payment research, and account documentation to support accurate, timely reimbursement. The ideal candidate has strong knowledge of healthcare billing, payer requirements, and revenue cycle operations, with the ability to identify reimbursement issues, resolve complex claims, and recognize opportunities for process improvement.
Job description
What You'll Do
- Review professional and institutional claims for accuracy, completeness, coding consistency, authorization status, and payer requirements.
- Validate patient, provider, insurance, coding, and billing information to ensure clean claim submission and accurate reimbursement.
- Research and resolve claim edits, clearinghouse rejections, denials, underpayments, unpaid claims, billing discrepancies, and reimbursement issues.
- Prepare and submit corrected, replacement, voided, and appealed claims in accordance with payer guidelines and timely filing requirements.
- Follow up on outstanding insurance and patient balances through final account resolution.
- Research payer policies, reimbursement guidelines, and claim requirements using payer portals and available resources.
- Review remittance advice, claim history, account documentation, and billing records to determine root causes and resolve payment issues.
- Identify recurring denial trends and reimbursement issues, escalating opportunities for process improvement to leadership.
- Maintain accurate, timely documentation of all account activity within the billing system.
- Comply with organizational policies, regulatory requirements, and perform other duties as assigned.
What You'll Bring
- 2–5 years of experience in patient accounts, insurance follow-up, denial management, healthcare billing, or revenue cycle operations.
- Experience with Medicare and/or Medicaid professional and institutional billing preferred.
- Strong knowledge of claims processing, accounts receivable, appeals, denial management, payer reimbursement guidelines, and outpatient reimbursement methodologies.
- Working knowledge of CPT, HCPCS, ICD-10 coding, NCCI edits, medical necessity, and authorization requirements.
- Experience using billing systems, clearinghouse platforms, and payer portals; experience with Raintree, Waystar, Inovalon, Wellpoint Federal, and ePaces is preferred.
- Strong analytical, organizational, and problem-solving skills with exceptional attention to detail.
- Ability to interpret remittance advice, claim status responses, and payer correspondence.
- Proficiency in Microsoft Office.
- Excellent communication and customer service skills with the ability to build positive relationships with patients, payers, and colleagues.
- Ability to prioritize competing deadlines while maintaining accuracy and meeting timely filing requirements.
Requirements
- 2–5 years of experience in patient accounts, insurance follow-up, denial management, healthcare billing, or revenue cycle operations.
- Experience with Medicare and/or Medicaid professional and institutional billing preferred.
- Strong knowledge of claims processing, accounts receivable, appeals, denial management, payer reimbursement guidelines, and outpatient reimbursement methodologies.
- Working knowledge of CPT, HCPCS, ICD-10 coding, NCCI edits, medical necessity, and authorization requirements.
- Experience using billing systems, clearinghouse platforms, and payer portals; experience with Raintree, Waystar, Inovalon, Wellpoint Federal, and ePaces is preferred.
- Strong analytical, organizational, and problem-solving skills with exceptional attention to detail.
- Ability to interpret remittance advice, claim status responses, and payer correspondence.
- Proficiency in Microsoft Office.
- Excellent communication and customer service skills with the ability to build positive relationships with patients, payers, and colleagues.
- Ability to prioritize competing deadlines while maintaining accuracy and meeting timely filing requirements.
Benefits
- Paid time off
- Sick time
- 6 major holidays
- Company-matched 401(k)
- Pre-tax transit and parking benefits
- Pet insurance
- Telehealth support
- Exclusive discounts
Company overview
Professional Physical Therapy is a leading provider of comprehensive physical therapy and rehabilitation services headquartered in Melville, New York. Founded in 1998, the company has grown to become one of the largest physical therapy networks in the United States, operating over 200 state-of-the-art facilities across New York, New Jersey, Connecticut, Massachusetts, and New Hampshire. The company specializes in orthopedic and sports physical therapy, offering customized recovery plans for patients recovering from injuries, surgeries, or managing chronic conditions. Their multidisciplinary team includes licensed physical therapists, certified athletic trainers, strength and conditioning specialists, hand therapists, and ergonomic workplace solutions experts. Professional Physical Therapy operates the Professional Athletic Performance Center, a 20,000 square foot facility on Long Island dedicated to athletic performance enhancement and injury prevention. The company also provides athletic training services to local schools and sports organizations, continuing education programs for healthcare professionals through Professional Seminars, and nationally recognized clinical affiliation programs for students. With a patient-centered approach and commitment to clinical excellence, Professional Physical Therapy has earned over 20,000 positive patient reviews and maintains Great Place to Work® certification for its employee-focused culture.