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Accounts Receivable (AR) Representative - ASC Division

Alliance Health Systems -
Remote

Quick Apply

Job Details

Full-time
$20 - $30 an hour

Benefits

Paid holidays
Health insurance
Dental insurance
Paid time off
Vision insurance
401(k) matching

Qualifications

Appeals
Medical insurance appeals management

Full Job Description

Accounts Receivable (AR) Representative - ASC Division

Location: ***REMOTE/Hybrid/Matawan, NJ****
Entity: Alliance Health 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 within a fast-paced Ambulatory Surgery Center (ASC) environment.

Alliance Health Systems

Alliance Health System provides the operational foundation that allows healthcare organizations and providers to focus on what matters most: delivering exceptional patient care. Through practice management, administrative support, operational strategy, technology, recruiting, marketing, human resources, and business services, we help healthcare teams operate more efficiently and effectively.

At Alliance, we believe every process can be optimized, every challenge presents an opportunity, and every team member plays a role in creating better outcomes for the patients that entrust us with their care. Our culture is built on collaboration, accountability, innovation, and a relentless pursuit of becoming Better Every Day.

If you are passionate about solving problems, improving systems, supporting high-performing teams, and making a meaningful impact behind the scenes of healthcare, we want to collaborate with you! Alliance Health System offers an opportunity to grow your career while helping our healthcare organizations change lives for the better.

Key Responsibilities:

Accounts Receivable & Follow-Up

Monitor and manage assigned AR work queues and aging reports
Perform timely follow-up on unpaid, denied, and underpaid claims
Contact insurance payers via phone and payer portals to determine claim status and expedite payment
Maintain detailed documentation of all account activity in the practice management system

Out-of-Network (OON) Account Management

Handle complex 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 root cause
Investigate and resolve claim denials related to coding, authorization, eligibility, or medical necessity
Prepare and submit appeals with appropriate clinical and billing documentation
Track denial trends and report recurring issues to management
Rework denied claims to recover revenue and reduce write-offs

Reporting & Productivity

Meet daily productivity and quality metrics (e.g., accounts worked, resolution 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 root causes and improving upstream revenue cycle processes

Qualifications

2+ years of healthcare 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 revenue cycle processes
Commercial insurance and payer guideline
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 complex OON claims
Persistence in payer follow-ups and appeals
Ability to prioritize high-impact accounts
Attention to detail with accurate documentation
Knowledge of payer-specific behaviors and escalation paths
Proficiency in SIS (Practice Management Systems), Availity, Waystar, and Microsoft Office

Job Type:

Full-Time
Monday-Friday
Remote

Benefits:

401(k) matching
Medical, Dental & Vision
Paid Time Off
Sick Time
Paid Holidays

Background Check Requirement: Employment is contingent upon the successful completion of a background check, which may include verification of employment history, education, criminal records, and other relevant information as permitted by law

Quick Apply

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