Accounts Receivable Specialist, Oshi Health

• Bachelor's Degree in Business Administration or relevant course work
• 2+ years of healthcare revenue cycle experience with a focus on accounts receivable, payment posting, or insurance billing
• Knowledge of medical billing, insurance claims processing, and payer reimbursement
• Experience resolving claim denials, underpayments, and payment discrepancies
• Experience posting payments and reconciling ERAs, EOBs, deposits, and unapplied cash
• Experience working successfully in a remote work environment with the ability to manage priorities independently
• Proficiency with EMR and medical billing systems
• Strong analytical, problem-solving, and organizational skills with excellent attention to detail
• Excellent communication and customer service skills
• Proficiency with Google Workspace (Sheets, Docs, Gmail) and the ability to quickly learn new systems and technology

Desirable

• Reports To: Lead Revenue Cycle
• Schedule: Monday- Friday 9-6pm EST
• As an Account Receivable Specialist, you will be responsible for managing insurance accounts receivable and ensuring accurate, timely posting and reconciliation of payments
• This role focuses on maximizing reimbursement through proactive claim follow-up, denial resolution, payment investigation, and cash reconciliation. You will work closely with our Revenue Cycle leads, other members of the Revenue Cycle team, finance, and clinical teams to resolve payment discrepancies, improve AR performance, and maintain accurate financial records
• This role also supports reporting and identifies trends to improve revenue cycle processes and overall financial performance. Your attention to detail, excellent organizational skills, and commitment to customer access will contribute to the financial stability and success of Oshi as we pioneer the way in GI care
• Manage assigned insurance accounts receivable to ensure timely reimbursement and reduce aging balances
• Follow up with insurance payers on outstanding claims, underpayments, denials, and payment discrepancies
• Investigate and resolve claim denials by submitting corrected claims, appeals, reconsiderations, and supporting documentation in accordance with payer requirements
• Review claim edits and rejections to ensure accurate resubmission and minimize future denials
• Accurately post insurance payments, adjustments, and remittances into the billing system
• Perform daily payment reconciliation by ensuring posted payments align with electronic remittance advice (ERA), explanation of benefits (EOB), bank deposits, and payment reports
• Research and resolve unapplied cash, payment variances, overpayments, and underpayments
• Reconcile payer payments against contracted reimbursement rates and escalate payment discrepancies as appropriate
• Maintain accurate documentation of AR activities, payer communications, payment research, and resolution outcomes
• Respond professionally and empathetically to patient inquiries regarding insurance claims, billing statements, payment activity, balances, and Oshi's billing model, policies, procedures, and applicable healthcare regulations
• Maintain open communication with providers, payers, and internal stakeholders to investigate, resolve, and prevent claim and payment issues
• Collaborate with Billing, Eligibility & Benefits, Credentialing, Finance, Clinical Operations, and other cross-functional teams to resolve reimbursement issues and improve revenue cycle performance
• Analyze accounts receivable, payment, and denial data to identify trends, root causes, and opportunities for process improvement
• Monitor and report on AR performance, payment posting accuracy, denial trends, aging, and other key revenue cycle metrics, providing insights and recommendations to leadership
• Support month-end close activities, payment balancing, reporting, and audit requests
• Identify recurring reimbursement or operational issues and recommend process improvements to improve payment accuracy, accelerate cash collections, and reduce denials
• Ensure compliance with organizational policies, payer requirements, financial regulations, HIPAA, and healthcare billing standards while maintaining accuracy and integrity in all revenue cycle activities