Description
Accounts Receivable Specialist
Full-time · Reports to RCM Manager · Remote
Role Overview
As our Accounts Receivable Specialist, you'll own the follow-through on claims after they're submitted — chasing down payment, resolving denials, and closing the gap between care delivered and cash collected. You'll work closely with our RCM and claims platform (Candid), our scheduling/EMR system, and our billing leadership to keep receivables moving instead of aging. This is a hands-on, high-impact role at a company where collection speed and accuracy directly determine how fast we can grow.
What You'll Own
- Manage an assigned book of insurance accounts receivable, working claims from submission through final resolution to keep aging balances down.
- Follow up with payers on outstanding claims, underpayments, and payment discrepancies, and drive them to close.
- Investigate and resolve claim denials and rejections — corrected claims, appeals, and reconsiderations with the documentation payers require.
- Review claim edits and rejections before and after submission to reduce repeat denials, partnering with our RCM team on root causes.
- Post and reconcile insurance payments, adjustments, and remittances accurately and on schedule.
- Research and resolve unapplied cash, overpayments, and underpayments against contracted reimbursement rates.
- Track and report on AR aging, denial trends, and payment posting accuracy, feeding directly into our weekly RCM flash report.
- Respond professionally to patient questions about claims, balances, and billing, and escalate payer or system issues to the right owner.
- Flag recurring reimbursement or process issues and recommend fixes that reduce denials and speed up collection.
What Success Looks Like
- Cash collection rate climbs measurably toward our company target
- Denials in your book get resolved rather than aged out — fewer claims sit past timely filing deadlines.
- Payment posting is accurate and current, so RCM reporting reflects reality rather than a backlog.
- Patterns you catch (a payer, a code, a workflow gap) turn into process fixes, not just one-off saves.
What You'll Bring
Required
- 3+ years of healthcare revenue cycle experience with a focus on accounts receivable, payment posting, or insurance billing.
- Working 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.
- Comfort working remotely and managing your own priorities and queue.
- Strong attention to detail and organizational skills — this role is the difference between revenue earned and revenue collected.
Preferred
- Experience in a startup or high-growth healthcare or telehealth organization.
- Familiarity with Candid, Availity, or similar claims and payer-connectivity platforms.
- Women's health, maternal health, or lactation coding experience.
- CRCR, CPB, CPC, or other healthcare revenue cycle certification.
Compensation & Benefits
- Salary range: $55,000–$70,000
- Unlimited PTO plus company holidays.
- 401(k) eligibility.
- Remote-first, with the flexibility that comes with it.
How We Work
This role sits inside our RCM and collections function and works closely across operations, finance, clinical, and product teams. Expect a fast pace, direct feedback, and a team that would rather fix the root cause of a denial than resubmit and hope.
About SimpliFed
SimpliFed gives parents the tools they need to navigate baby feeding questions, concerns, and obstacles, starting in pregnancy and through the feeding journey. Our platform, mOS, connects families to licensed lactation and maternal health providers through partnerships with DME suppliers, health systems, and OB practices. We're a Series A company growing fast, and our operational and revenue infrastructure needs to grow with us.
About You
- Aligned with SimpliFed’s mission.
- Hankering to put the relationships back in medicine
- A posture towards execution - a true operator willing to both develop the strategy and execute it.
- Ability to work remotely and communicate asynchronously via slack and email, along with thriving in virtual meetings.
- Does not suffer in silence: willingness to give it a shot but then reach out for help as needed and not waiting too long.
- Leans into items they are uncomfortable with, not avoid it.
- Defers to safe and secure security protocols always to protect SimpliFed’s patients and providers.
- High personal integrity to always do the right thing for the families that we are honored to serve.
- Respect and high tolerance for bureaucracy, along with an optimistic perspective on how to operate within the bureaucratic “rules” and the healthcare regulatory environment.
- Ability to work in a fast paced, team environment.
- Have a valid Drivers License and REAL ID
- Applicants must be currently authorized to work in the United States on a full-time basis
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