Accounts Receivable (AR) Specialist — AI-Enabled RCM

About Protego:

Protego Health is a revenue cycle team that pairs experienced RCM specialists with smart automation and AI tools built to make their work easier. Our software can prevent up to 46% of denials at the point of claim creation and helps automate appeals by pulling in individual payer policies so AR work moves faster. We started this work after the founder’s brother faced a cascade of unfair denials over eight surgeries for colitis resulting in $1 million in bills. Our mission is simple: get providers paid correctly so patients don’t get the bill.

This role supports a rural community hospital engagement where Protego has assumed management of the hospital’s revenue cycle department. You will help stabilize billing operations, work down aged accounts receivable, and build the workflows and training that the hospital’s own team will eventually take over. This is hands-on, high-impact work where the results show up in the hospital’s cash flow and in patients not receiving bills they shouldn’t.

Position Overview

We are hiring for 2 AR specialists ($20-$25 per hour) and one senior AR specialist ($25-$30 per hour). Salary based on location and experience - the latter role requires significantly more experience. Full benefits through Protego Health.

The Accounts Receivable (AR) Specialist owns the full life of a claim after it leaves the door: daily claim queues, rejections and edits, denials and appeals, and follow-up on aged insurance balances. This position works inside Oracle Health (Cerner) Revenue Cycle and the SSI Group clearinghouse for a hospital and clinic environment that bills both governmental and commercial payers. Experience with Cerner and SSI is highly preferred; strong hospital (UB-04) and professional (CMS-1500) billing experience is required.

Reports to: Protego Engagement Lead

Schedule: Full-time, remote, aligned to Mountain Time business hours

Key Responsibilities:

Daily Billing Operations

• Review and process daily claim queues; submit clean claims to governmental and commercial payers.
• Correct claim edits, billing errors, and front-end rejections; resolve billing holds and work queues.
• Ensure claims transmit timely and accurately through SSI, and support the transition of remaining paper payers to electronic 837/835 transactions.

Denials Management

• Review denied claims daily, investigate root cause, and prepare and submit appeals within payer timelines.
• Work medical necessity, eligibility, authorization, coding-related, coordination of benefits, and timely filing denials.
• Coordinate with coding, registration, and clinical departments to resolve denials at the source.
• Identify denial trends and recommend workflow improvements to prevent recurrence.

Accounts Receivable Follow-Up

• Work aged insurance balances with priority on accounts over 90, 180, and 365 days, high-dollar balances, and government payers.
• Perform payer follow-up by phone, payer portals, and written correspondence.
• Identify underpayments and payment variances against contract terms and escalate reimbursement issues.
• Contribute to month-end AR reporting: claims submitted, corrected and rebilled, denials resolved, appeals submitted, and accounts worked.

Expectations

• Maintain HIPAA compliance and follow hospital policies and procedures at all times.
• Document all account activity contemporaneously and completely in the patient accounting system.
• Meet productivity and quality standards established during onboarding.
• Communicate barriers promptly to the Protego engagement lead.

Qualifications:

• 3+ years of critical access hospital accounts receivable, billing, or revenue cycle experience.
• Working knowledge of UB-04 and CMS-1500 claim requirements, Medicare, Medicaid, and commercial payer rules.
• Strong denial management and appeal writing skills with a track record of overturning denials.
• Hands-on experience with Oracle Health (Cerner) Revenue Cycle and SSI Group highly preferred.
• Excellent attention to detail, organization, and problem solving; comfortable working independently in a remote setting.
• Clear written and verbal communication, including with hospital leadership and clinical staff.

Preferred Skills

• Critical access hospital, rural health clinic, or swing bed billing experience.
• Knowledge of CPT, ICD-10, HCPCS, and revenue code terminology.
• Experience with 835 remittance reconciliation and clearinghouse edit managem…