Optima Medical · 19 hours ago
A/R Denials Specialist.
Scottsdale, AZ(Hybrid 1-Day in Office)
Full-time
Hybrid
Entry, Mid Level
2+ years expOptima Medical is an Arizona-based medical group dedicated to improving healthcare quality across the state. The A/R Denials Specialist is responsible for managing accounts receivable, reviewing denied claims, and ensuring timely follow-up with insurance carriers to enhance patient and provider experiences.
Health Care
Responsibilities
Follow up on insurance claims to ensure timely and accurate payment
Review, research, and correct denied or rejected claims; resubmit as necessary
Communicate with insurance carriers to resolve claim issues and discrepancies
Identify payer trends and provide feedback to management
Navigate insurance portals to verify claim status, eligibility, and payer notes
Maintain accurate and detailed documentation of all claim activity, denials, appeals & adjustments
Identify and escalate credentialing or contracting issues
Maintain an organized follow-up bucket with accurate claim status and next actions
Review and resolve daily denials assigned by remit code per payer and company guidelines, including:
Bundled or Non-Covered Services
Lack of Medical Necessity
Insurance Eligibility / Demographic Issues
Out-of-Network / Credentialing
Modifiers, POS, CLIA #
Qualification
Required
Minimum 2–3 years of experience in medical billing, denials, and A/R follow-up
Strong understanding of EOBs, ERAs, payer rules, and revenue cycle processes
Experience working with claim management and EHR systems
Excellent communication, organization, and problem-solving skills
Preferred
Primary Care (PCP) billing experience preferred
Company
Optima Medical
Optima Medical is a healthcare center that provides personalized healthcare.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Ken Walsh
Chief Financial Officer
Eric Battis
Chief Operating Officer
Company data provided by crunchbase