• Manages all functions of Accounts Receivable, including day-to-day functions as well as any journal entries, reporting, or reconciliations during month end close. • Verify and post customer payments (check, ACH, wire, credit card) ensuring application to correct customer and invoice(s). • Review orders on finance hold; communicate efficiently with sales & operations teams or the customer to resolve the hold. • Process credit applications for customers requesting terms, including reaching out to references, reviewing credit reports, & recommending a credit limit for approval to assistant controller. • Gather and review resale certificates for customers; ensure customer record is set up accordingly; monitor expiration dates of certificates to ensure there is always a valid copy on file. • Continually monitor and review open AR; send collections emails to customers for past due balances and escalate as needed. • Prepare weekly AR Aging report for review with assistant controller. • Process credit memos for customer returns. • Maintain a good relationship with customers by responding to all inquiries in a timely manner and resolving any account discrepancies. • Complete month end closing tasks including accruals & reconciliations. • Assist with monthly sales tax filing. • Continually monitor processes and raise issues or suggestions to assistant controller where improvements are needed. • Any ad hoc reporting or tasks as requested by controller or assistant controller. • Assist with special projects as needed.

Role Description Optima Dermatology is recruiting a full time RCM Accounts Receivable Specialist to join our Practice Support Center, based in Portsmouth, NH. Remote opportunities available for residents of ME, NH, MA, IN, OH, FL, NC. The Accounts Receivable Specialist is responsible for resolving aging claims, working denials, overseeing secondary claims, and collaborating closely with other revenue cycle teams to ensure timely and accurate resolution of accounts. This position also involves patient account management, requiring strong communication and critical thinking skills. Responsibilities - Claims Management (Accounts Receivable): - Review and resolve rejected claims, ensuring accuracy and meeting deadlines. - Research and validate posted payments and adjustments, correcting discrepancies as needed. - Post EOBs, payments, and adjustments as required to resolve outstanding claims. - Process correspondence to resolve open A/R balances for assigned providers, payers, and claims. - Analyze denials and underpayments to determine if appeals or other resolutions are necessary. - Identify and communicate denial and payment trends to improve billing procedures. - Collaborate with payers, EDI, and payment posting teams to address systemic issues and streamline processes. - Resubmit claims to secondary/tertiary payers as needed. - Maintain accurate logs of payer interactions and unresolved balances. - Utilize provider portals and payer resources to research and resolve claim processing issues. - Manage incoming calls from insurance companies regarding claims and requests for additional documentation to process submitted claims. - Understand and interpret insurance Explanations of Benefits (EOBs). - Patient Accounts Management: - Provide excellent customer service, assisting patients with billing inquiries, account balances, and financial responsibilities. - Manage incoming patient calls efficiently, resolving concerns, and escalating issues as needed. - Assist clinical and operational staff with patient demographics, scheduling, and referrals. - Educate patients on cost and payment options for services. - Analyze and resolve patient account billing issues through communication with patients, insurance providers, and healthcare systems. - Demonstrate effective call handling, including deescalating patients, by managing incoming patient calls via the phone queue. - Verify insurance eligibility and benefits as needed using automated eligibility systems, payer websites, and/or calls to the insurance carriers. - General and Administrative: - Keep management informed about backlogs, time availability, and unresolved concerns. - Maintain set standards, metrics, all KPIs and ensure individual and departmental goals are met. - Accurately document patient accounts and all actions taken. - Respond promptly to emails, voicemails, and assigned tasks. - Maintain a thorough understanding of the practice management system and electronic medical records (EMR). - Function as a resource to answer questions promptly and accurately. - Work as a collaborative team member within a distributed organization. - Participate in revenue cycle projects and contribute to departmental goals. - Work assigned intradepartmental and interdepartmental inquiries within a timely manner. - Follow all HIPAA guidelines and comply with annual training. - Demonstrate our values in interactions, empathy, and sensitivity towards patient/family rights. - Other duties assigned by the Supervisor, Manager, or Director. Qualifications - Minimum of 3 years in healthcare reimbursement preferred. - Knowledge of CPT and ICD-10 coding. - Familiarity with payer billing guidelines, submission, and remittance processes. - Experience with HCFA 1500 forms and Explanation of Benefits (EOBs). - Strong problem-solving, prioritization, and follow-through abilities. - Excellent interpersonal and communication skills, with a proven record of professional etiquette. - Ability to work independently in a demanding environment. - High school diploma or equivalent (knowledge of business administration and/or accounting preferred). Degree/certification or structured secondary education strongly preferred. - Strong initiative, judgment, and decision-making skills. - Ability to build rapport with patients and colleagues while maintaining empathy and sensitivity. - Collaborative collaborator within a distributed organization. - Adherence to company values, professionalism, and HIPAA compliance. Benefits - Generous health, dental, vision, disability, and life insurance.

• Managing end-to-end OTC processes, including customer credit management • Billing, cash application, collections, dispute and deduction handling • Customer master data management, and month-end closing and reporting • Ensuring timely invoicing and collection of receivables • Analyzing and approving new customer credit applications • Assessing customer creditworthiness • Preparing credit recommendations, proposals, and supporting documentation • Forecasting, reviewing, and updating customer credit limits and payment terms • Performing periodic reviews of existing customer accounts • Preparing and distributing credit and collections reports • Generating customer billing data • Validating billing accuracy • Managing customer payments • Reconciling AR activity • Preparing and distributing AR operational and management reports • Communicating and negotiating with customers regarding overdue balances

• Manage the day-to-day activities of the staff supervised on site or remotely for a client hospital. • Monitor the status of outstanding patient accounts, identifying and resolving billing errors and claim denials. • Conduct weekly team meetings driving revenue cycle performance needs and continued training, maintain and track SOP’s and process improvement processes. • Implement strategies to improve collection rates and reduce outstanding accounts receivable. • Follow up on complex payer trends, communicate with Management the volume and specific issue along with researched payer specific guidelines.