Lead Aging Account Receivable Specialist

Position Summary

The Lead Aging Accounts Receivable Specialist oversees the follow-up and resolution of outstanding patient and payer balances to support the financial health of Park West Health System. This role is responsible for monitoring aging reports, prioritizing high-risk accounts, and leading complex claim resolution efforts to ensure timely reimbursement and reduction of uncompensated care.

Working closely with the Director of Business Operations, billing team members, and external payers, the Lead Specialist serves as a subject matter expert on denial management, payer trends, and accounts receivable workflows. The role provides guidance and support to team members, identifies process improvement opportunities, and helps ensure compliance with payer requirements and organizational policies.

The Lead Aging Accounts Receivable Specialist also collaborates with front-end and clinical teams to address root causes of billing delays and promotes efficient revenue cycle practices that align with Park West's operational goals and commitment to service excellence.

Essential Functions

• Monitor aging reports to identify delinquent accounts and take appropriate action to collect outstanding balance

• Serves as an advocate to troubleshoot problems within the Medical Registration area that can cause billing delay in reimbursement

• Responsible for the daily charge entry of the Billing Department for all patient accounting and related functions. This includes accounts receivable, billing, credit, and collections.

• Prepare and submit billing to insurance companies or other payers

• Follow up on delinquent claims and past due invoices

• Manage Medicare and Medicaid claims

• Uses coded data to produce claims to insurance companies

• Reviewing and appealing denied and unpaid claims

• Verifies patients insurance coverage as well as answers patients billing questions

• Works and maintains assigned receivable through work queues, age trail balance reports (ATB's), and special projects to achieve established departmental goals through resolution of outstanding account balances and reduction of uncompensated care.

• Ensures correct processing of outstanding insurance claims by:

• Interpreting insurance payer responses

• Requesting account level adjustments

• Submitting appeals and claims reconsiderations

• Evaluating financial responsibility of patients

• Resolving insurance denials and claim rejection

• Performing insurance verification

• Assists with Front Desk Registrar duties as needed to support clinic operations and ensure seamless patient flow.

Core Responsibilities and Organizational Expectations

In addition to role responsibilities, every employee has the following responsibilities as a part of their employment:

• Provides courteous, responsive, and service-oriented support to patients, visitors, and colleagues. Promotes a respectful and welcoming environment, communicates clearly, and works collaboratively to support team and organizational goals.
• Performs all duties in a manner consistent with Park West Health System's mission, vision, and organizational values, demonstrating a commitment to quality care, respect, and service excellence.
• Adheres to all applicable federal, state, and local regulations, as well as organizational policies and procedures, including HIPAA, privacy, and security standards.
• Follows all infection control, workplace safety, and risk management protocols. Participates in quality improvement and performance initiatives as appropriate to the role.
• Maintains professionalism, reliability, and accountability in attendance, performance, and communication; completes required trainings; participates in staff meetings and organizational initiatives
• Performs other duties on an as-needed basis.

Qualifications

• High school diploma or equivalent required.
• Minimum of five (5) years of experience in a medical billing or revenue cycle environment required.
• Minimum of five (5) years of experience in customer service, patient relations, or a related healthcare support role required.
• Experience working in a Federally Qualified Health Center (FQHC) or community health setting preferred.
• Experience using electronic health record (EHR) and practice management systems required.
• Working knowledge of medical terminology obtained through formal training or relevant work experience required.
• Proficiency with computer systems, including electronic billing and practice management platforms, required.

Skills

• Advanced knowledge of accounts receivable follow-up, denial management, and payer resolution strategies
• Strong analytical skills with the ability to identify trends, root causes, and process improvement opportunities
• Ability to interpret explanation of benefits (EOBs), remittance advice, and payer correspondence accurately
• Excellent organizational and time-management skills with the ability to manage large volumes of accounts and competing priorities
• Strong problem-solving skills with the ability to independently resolve complex billing issues