Remote Claim Processor Jobs in Augusta, GA (NOW HIRING)

Accounts Receivable Specialist

Full-Time, M–F  •  Must be located in: WA, OR, ID, UT, AZ, TX, VA, FL, GA, or PA

About United Wound Healing

Our mission to transform wound care and improve lives is challenging — but absolutely worth it. One in ten skilled nursing facility residents will develop a skin condition requiring expert medical care, and one in four patients goes home with an open wound. Every one of those people deserves the very best care available. Our providers bring hands-on expertise, education, and compassionate care to patients and their care teams so that their wounds can heal faster. At United Wound Healing, we’re not just treating wounds; we’re raising the standard of care, one patient at a time.

Compensation & Benefits

Salary: $24.00–$27.25 hourly (DOE & location) | Hourly, Non-Exempt | Full-Time | Location: Remote/In-Office

* Remote: Must be located in one of the following States: WA, OR, ID, UT, AZ, TX, VA, FL, GA, PA 

* In-Office: Required to work in the office if you live within 20 miles of the corporate headquarters

Health & Wellness

• Medical, Dental, Orthodontic, Vision, and Rx — 80% of employee monthly premiums covered; dependent coverage available at employee’s expense
• Employer-sponsored Life, AD&D, and Disability Insurance
• Voluntary supplemental plans: Accident, Cancer, Critical Illness, STD, Identity Protection, and more

Time Off

• Accrue up to132hours (16.5 days) of PTO in your first year, based on FTE status
• 8 paid holidays for full-time employees

Financial & Career Growth

• 401(k) with employer match on first 4%
• Up to $2,000 annually forprofessional development(prorated based on FTE)

Work-Life Quality

• Monday–Friday schedule | Typical hours 7:30 AM – 4:00 PM PST (occasional overtime based on work volume)
• Core Values that promote work-life harmony
• A collaborative, team-driven culture that promotes recognition and celebrates everyday wins

What You Bring

• Credentials:CPB preferred but not required; CPC(or CPC-A)preferred but not required
• Experience:3+ years of medical billing and accounts receivable experience required
• Revenue Cycle: Advanced expertise in the revenue cycle management process and insurance claims processing cycle
• Claims Knowledge:Strong ability to read and understand EOBs; deep understanding of insurance denials and unresolved claims resolution; knowledge of ICD-10, CPT, HCPCS, and CMS-1500 claim format
• Technical: Proficient in MS Office — Outlook, Excel (intermediate), and Word; skilled with computers and multiple web browsers
• Soft Skills: Critical thinker with strong problem-solving skills; high attention to detail; excellent organization and time management; ability to prioritize and manage time-sensitive situations with urgency
• Communication: Strong verbal and written communication and customer service skills; effective communication with partner facilities, co-workers, patients, and insurance companies
• Character: Consistently dependable, honest, trustworthy, and professional; able to work independently; adaptable to changing procedures and a growing environment

What You’ll Do

Payment Posting & Remittance Processing

• Perform daily payment posting of incoming insurance and patient receipts with a high level of accuracy and efficiency.
• Review and process Electronic Remittance Advice (ERA) files and resolve held ERA transactions.
• Apply payments, contractual adjustments, denials, and other transactions to patient accounts accurately according to remittance detail.
• Manually post paper remittances and accurately interpret remittance details.
• Research unidentified payments, recoupments, and non-matching transactions to determine the appropriate account and transaction.
• Process insurance takebacks through ERA transactions and complete refund requests as appropriate.

• Investigate and resolve payment discrepancies and posting issues.
• Maintain accurate and timely posting to support account balances, reconciliation, and downstream A/R activities.

Accounts Receivable & Claim Resolution

• Investigate and resolve unresolved claims, including denials, underpayments, and delayed payments.
• Troubleshoot claim issues and submit written appeals with appropriate supporting documentation and timely follow-up.
• Identify the root cause of denial issues, payment delays, and other reimbursement problems; communicate trends to management and support corrective action.
• Identify and communicate denial trends and coding issues that may impact clean claim processing and reimbursement.
• Resolve assigned A/R worklist items and document all account activity thoroughly and accurately.

Insurance Verification & Payor Management

• Verify patient eligibility and identify missing or incorrect insurance information.
• Identify payor changes and accurately update coordination of benefits (COB).
• Accurately identify the appropriate insurance payor(s) for claim and payment processing.
• Navigate insurance payor portals to verify eligibility, research claims, payment information, and other account details.
• Maintain current knowledge of payor guidelines, reimbursement policies, and payment requirements.

Account Reconciliation & Communication