Accounts Receivable (A/R) Specialist - Medical Billing
Optima Medical
Salary undisclosed
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Description
About Optima
Optima Medical is an Arizona-based medical group consisting of 34 locations and over 150+ medical providers, who care for more than 200,000 patients. Our mission is to improve the quality of life throughout Arizona and Nevada by helping communities "Live Better, Live Longer" through personalized healthcare, with a focus on preventing the nation’s top leading causes of death. We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in-house lab testing, imaging, chronic disease management, and other specialty health services. We aspire to aid the growth of our company by welcoming the most qualified and deserving candidates aboard.
Position Summary: The A/R Specialist is responsible for managing accounts receivable (A/R), reviewing and correcting denied or rejected claims, and ensuring timely follow-up with insurance carriers. This role requires strong knowledge of healthcare payer guidelines, claim workflows, and primary care billing practices.
Responsibilities
Claims Management
- Follow up on insurance claims to ensure timely and accurate payment.
- Review, research, and correct denied or rejected claims; resubmit as necessary.
- Communicate with insurance carriers to resolve claim issues and discrepancies.
- Work claims through final resolution, not just follow-up activity, ensuring appropriate reimbursement or adjustment.
- Independently research and resolve complex claim denials, including medical necessity, coding-related denials, appeals, and payer escalations.
- Identify payer trends and provide feedback to management.
- Identify recurring denial patterns and provide feedback to management on opportunities to prevent future denials.
- Navigate insurance portals to verify claim status, eligibility, and payer notes.
- Maintain accurate and detailed documentation of all claim activity, denials, appeals, and adjustments.
- Identify and escalate credentialing or contracting issues.
Denials & Follow-Up
- Maintain an organized follow-up bucket with accurate claim status and next actions.
- Review and resolve daily denials assigned by remit code per payer and company guidelines, including:
- Bundled or Non-Covered Services
- Lack of Medical Necessity
- Insurance Eligibility / Demographic Issues
- Out-of-Network / Credentialing
- Modifiers, POS, CLIA #
- Manage and aggressively work aging A/R balances, including claims exceeding 90 and 120 days, to ensure timely resolution and payment.
- Analyze recurring denial trends and collaborate with internal teams to identify root causes and reduce repeat denials.
Qualifications
- Minimum 3–5 years of experience in medical billing, denials management, and A/R follow-up, preferably with experience handling complex A/R accounts and denials.
- Primary Care (PCP) billing experience preferred.
- Demonstrated experience independently researching and resolving complex denials, appeals, and payer escalations.
- Experience managing aging accounts receivable, including claims aged 90+ and 120+ days.
- Strong understanding of EOBs, ERAs, payer rules, denial resolution strategies, and revenue cycle processes.
- Experience working with claim management and EHR systems.
- Experience with eClinicalWorks (eCW) is preferred.
- Excellent communication, organization, analytical, and problem-solving skills.
Why Join Our Team?
- Substantial growth opportunities
- Leadership and mentoring
- Fun work environment (happy hours, lunches, events, holiday parties)
- Comprehensive benefits (medical, vision, dental, 401k, paid holidays)
- Supportive and positive work environment
Benefits
- 401(k)
About this role
Optima Medical, a 34-location Arizona-based medical group, is seeking an A/R Specialist to manage the full lifecycle of insurance claims and denials across their primary care operations. You'll own claim follow-up from submission through final resolution, independently researching and correcting denied claims while communicating directly with insurance carriers to resolve discrepancies. The role demands hands-on expertise in denial management—handling medical necessity issues, coding problems, eligibility disputes, and credentialing gaps—plus the ability to spot patterns in recurring denials and escalate systemic problems to management.
This position requires 3–5 years of medical billing and A/R experience, with a strong track record managing complex denials and aging accounts (90+ and 120+ days old). You'll need solid knowledge of EOBs, ERAs, payer rules, and revenue cycle workflows, plus comfort navigating insurance portals and claim management systems. Primary care billing experience and familiarity with eClinicalWorks are preferred. The role is full-time and in-office in Scottsdale, Arizona.
If you thrive on problem-solving, have the discipline to organize and prioritize a heavy follow-up workload, and want to make a tangible impact on revenue recovery for a growing healthcare provider, this could be a strong fit. Optima offers standard benefits, paid time off, and a collaborative environment with growth opportunities.
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Pay for this role
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