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Job Description
Medical Biller & Accounts Receivable Specialist
ADIRA HEALTH
McAllen, TX Job Details Full-time $16•$20 an hour 1 day ago Benefits Paid time off Opportunities for advancement Flexible schedule Qualifications Appeals Accounts receivable Health insurance co-pays Medicare Process improvement Medicaid health insurance Aged receivables report Electronic health record (EHR) management for billing and coding Attention to detail Medical billing Medical insurance appeals management Medical explanation of benefits reviews Medicaid Medical billing account reconciliation Outbound calling Insurance claims appeal handling Medical debt collection accounts Collections account management Patient collections management
Medical Biller & Accounts Receivable Specialist Compensation:
$16•20 per hour
Employment Type:
Full-Time Location:
South Texas About ADIRA Health ADIRA Health is a growing primary care organization serving communities throughout South Texas. Through strong operational leadership and administrative infrastructure, ADIRA Health supports multiple clinic locations with a focus on quality patient care, financial accountability, and long-term growth. The Administration Department oversees Revenue Cycle Management, billing operations, financial performance, and AR reduction initiatives across all supported clinics. As we continue to expand, we are strengthening our Revenue Cycle team to improve cash flow, reduce aging accounts, optimize reimbursement performance, and ensure timely claim submission and payment collection. Position Summary The Medical Biller & Accounts Receivable Specialist is a key member of the ADIRA Health Administration Department (Revenue Cycle Management) and is responsible for ensuring accurate claim submission, timely reimbursement, effective denial resolution, and collection of outstanding patient balances. This position requires an experienced medical billing professional with 3-5 years of healthcare revenue cycle experience who is comfortable managing the full lifecycle of a claim—from claim creation and submission through payment posting and AR follow-up—while also actively collecting patient balances and reducing outstanding receivables.
The role is divided between:
50% Medical Billing, Insurance AR & Revenue Cycle Management 50% Patient Account Collections The ideal candidate has strong knowledge of medical billing processes, insurance claim follow-up, denial management, payment posting, patient collections, and payer reimbursement guidelines. This is a performance-driven role with direct impact on cash flow, AR days, net collection rates, and overall financial performance. Core Responsibilities 50%•Patient Account Collections Conduct daily outbound calls to patients with outstanding balances. Actively work assigned patient AR aging buckets (30+, 60+, 90+ days). Explain statements, EOBs, deductibles, copays, and coinsurance professionally and accurately. Establish structured payment plans in accordance with ADIRA Health policies. Follow up on broken payment plans and overdue balances. Improve patient collection percentages and reduce patient AR greater than 90 days. Document all communication accurately in the practice management system. Meet established productivity and collection targets. 50%•Medical Billing, Insurance AR & Revenue Cycle Management Medical Billing & Claim Submission Prepare, review, scrub, and submit electronic claims daily through the EMR and clearinghouse. Ensure claims are accurate, complete, and compliant prior to submission, including coding, modifiers, demographics, and insurance information. Identify and correct claim errors before submission. Monitor clearinghouse rejections and promptly resubmit corrected claims. Verify payer-specific billing requirements to reduce denials and delays. Maintain claim submission turnaround times within organizational standards. Insurance AR Management Actively work assigned insurance AR aging buckets (0-30, 31-60, 61-90, and 90+ days). Follow up on unpaid, underpaid, or delayed claims. Research reimbursement issues and identify root causes. Escalate recurring payer issues and trends to Revenue Cycle leadership. Denial Management Review, research, and resolve denied or rejected claims. Submit corrected claims and appeals within payer deadlines. Track denial trends and identify opportunities for process improvement. Maintain detailed documentation of all payer interactions and appeal activity. Payment Posting & Reconciliation Accurately post insurance and patient payments. Reconcile EOBs and ERAs. Apply contractual adjustments and write-offs appropriately. Assist with daily, weekly, and monthly reconciliation processes. Maintain posting accuracy and identify discrepancies requiring investigation. Performance Expectations Demonstrated reduction in AR aging. Improvement in patient collection rates. Consistent activity and documentation within assigned AR buckets. Timely claim submission and denial resolution. Accurate payment posting with minimal errors. Contribution to overall reduction in AR days. Positive impact on net collection rate and organizational cash flow. Required Qualifications 3-5 years of medical billing and healthcare revenue cycle experience (required). Strong patient collections experience. Experience with insurance follow-up, denial management, and appeals. Strong understanding of Medicare, Medicaid, Medicare Advantage, and commercial insurance plans. Ability to verify and interpret patient benefits, eligibility, deductibles, copays, coinsurance, and coverage limitations. Experience with EMR, practice management systems, and clearinghouses. Strong communication skills and professionalism during financial discussions. Highly organized with strong attention to detail. Ability to work independently in a structured, metrics-driven environment. Preferred Experience Primary care billing experience. Knowledge of CPT, ICD-10-CM, HCPCS, modifiers, and payer billing guidelines. Experience with claim scrubbing, clearinghouse management, and denial prevention. Basic to intermediate Excel proficiency, including aging reports, tracking logs, and reconciliation reports. Why Join ADIRA Health Growing healthcare organization with multiple clinic locations. Opportunity to directly impact financial performance and operational success. Structured Revenue Cycle Management environment with clear expectations and measurable outcomes. Career growth opportunities as ADIRA Health continues to expand throughout South Texas.
