Accounts Receivable Specialist-Medicare, Customer Service Operations

Cardinal Health • Raleigh, NC • 3h ago

Job Summary

The Accounts Receivable Specialist - Medicare is responsible for the timely follow-up and resolution of insurance claims. This role ensures accurate and efficient collection of outstanding balances from insurance payers, working to reduce aging accounts receivable and increase cash flow for the organization. This position is a Medicaid insurance associate on the revenue cycle management team.

Responsibilities

Review aging reports and work insurance accounts to ensure timely resolution and reimbursement.

Contact insurance companies via phone, portals, or email to check claim status, request reprocessing or escalate issues.

Analyze denials and underpayments to determine appropriate action (appeals, corrections, resubmissions).

Track and follow up on all submitted appeals until resolution.

Analyze explanation of benefits (EOBs) and remittance advice to determine the reason for denial or reduced payment.

Document all collection activities in the billing system according to departmental procedures.

Follow up on unpaid claims within payer-specific guidelines and timelines.

Coordinate with other billing team members, coders, and providers to resolve claim discrepancies.

Maintain up-to-date knowledge of payer policies, coding changes, and reimbursement guidelines.

Ensure compliance with HIPAA and all relevant federal/state billing regulations.

Flag trends or recurring issues for team leads or supervisors.

Meet daily/weekly productivity goals (e.g., number of claims worked, follow-ups completed).

Assist with special projects, audits, or other duties as assigned.

Qualifications

1-3 years of experience, preferred

High School Diploma, GED or equivalent work experience, preferred

Strong knowledge of insurance claim processing and denial management preferred.

Familiarity with Medicare, Medicaid, and managed care preferred.

Proficiency in billing software (e.g. Waystar, Noble House, etc.) and Microsoft Office Suite.

Excellent verbal and written communication skills.

Ability to work independently and manage time effectively.

Detail-oriented with strong analytical and problem-solving skills

What is expected of you and others at this level

Applies acquired job skills and company policies and procedures to complete standard tasks

Works on routine assignments that require basic problem resolution

Refers to policies and past practices for guidance

Receives general direction on standard work; receives detailed instruction on new assignments

Consults with supervisor or senior peers on complex and unusual problems

Anticipated hourly range: $20.02 per hour - $25.78 per hour

Bonus eligible: No

Benefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

Medical, dental and vision coverage

Paid time off plan

Health savings account (HSA)

401k savings plan

Access to wages before pay day with myFlexPay

Flexible spending accounts (FSAs)

Short- and long-term disability coverage

Work-Life resources

Paid parental leave

Healthy lifestyle programs

Application window anticipated to close: 4/17/2026 *if interested in opportunity, please submit application as soon as possible.

The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity.

Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.

To read and review this privacy notice click here (https://www.cardinalhealth.com/content/dam/corp/email/documents/corp/cardinal-health-online-application-privacy-policy.pdf)

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