How to Hire an Accounts Receivable Specialist: Credentials, Sourcing and Screening

An accounts receivable specialist works the claims you have filed and the money that has not arrived: unpaid claims, claims sitting in a payer's system, and denials nobody has picked up. In a practice the desk sits downstream of charge entry; in a billing company the same work spans many clients at once. Aging that nobody works grows quietly, and the deadlines buried in it start to bite.

If you want the role drawn from the worker's side first, our career guide covers what an accounts receivable specialist does, the settings it spans and how people move into it.

Day one, hold your hire to five concrete abilities:

• Read the remittance, not just the deposit. Electronic remittance advice travels on the ASC X12 835, HIPAA's adopted standard for health care payment and remittance advice. Your hire should trace one payment line back to the claim it touches and explain each adjustment on it aloud.
• Work an aging report by payer and age bucket. BLS describes billing and posting clerks, the closest occupational group to this desk, as calculating charges, generating bills, reviewing documents such as charge slips and hospital records, and contacting customers about accounts. On a payer-follow-up desk the counterpart on the phone is a payer; if the desk also owns patient balances, it is the patient.
• Hold deadlines without being reminded. Medicare requires most claims to be filed no later than 1 calendar year after the date of service (42 CFR 424.44). A Medicare redetermination, the first level of appeal, must be requested within 120 calendar days of receiving the initial determination notice, and receipt is presumed 5 calendar days after the notice date (42 CFR 405.942). Ask candidates to narrate what they would do with a claim approaching the end of its filing year and a denial deep into its redetermination window.
• Know what a payer's own clock looks like. Under Medicare's rules, clean claims received on or after October 1, 1993 must be paid or denied within 30 calendar days of receipt, and interest is owed on clean claims not paid within that period. That ceiling is the arithmetic behind escalating an old, otherwise-clean claim.
• Run your systems. Name your practice-management system, your clearinghouse and your payer portals in the interview exercise. Systems differ from shop to shop, so fluency in yours is a training investment, not a given.

Design the desk before you post it. Decide whether this role owns only payer follow-up or also patient balances and payment plans after the payer closes its part — where that line sits changes the skill profile. Our guide to hiring a patient account representative covers the patient-side version of the desk. If most of your aging is denials that need appeal packets rather than status calls, say so in the posting, because that is a different center of gravity.

The credentials that come up for this desk — AAPC's CPB, HFMA's CRCR and AAHAM's CRCS — are certifications issued by private professional bodies, not licenses. Whether your posting requires one, prefers one or skips it entirely is your hiring policy to set. What a credential tells you is what the issuing body says it validates, so start there:

• AAPC's CPB. AAPC describes the Certified Professional Biller as validating expertise in the medical billing process: claim submission, payment posting, insurance guidelines and revenue cycle workflows. It maps onto a desk that touches the whole claim cycle, from submission through posting.
• HFMA's CRCR. HFMA describes the Certified Revenue Cycle Representative as a national-level certification on the patient-centric revenue cycle, and says HFMA membership gives access to its certifications, most at no additional cost. It fits a desk that sits inside a broader revenue-cycle team.
• AAHAM's CRCS. AAHAM describes its certification family as a career ladder beginning with the Certified Revenue Cycle Specialist and culminating with the Certified Revenue Cycle Executive, with a professional-level exam for supervisors and managers. The entry rung maps directly onto AR work.

A credential says nothing about your payer mix, your systems, or whether the candidate can do the deadline arithmetic from the first section. Weight the working exercise in the next section above the letters — tracing a remittance and honoring a filing window are the work itself.

Credential names, eligibility rules and renewal requirements change. Confirm the current details with AAPC, HFMA or AAHAM before you write a credential into a posting or an offer.

Post where candidates already look. Our accounts receivable specialist jobs page lists openings next to the role's career guides, and our guide to where to post billing and coding jobs walks the boards and channels beyond it.

Search the neighboring titles too. O*NET lists Accounts Receivable Specialist (AR Specialist) among the sample titles for bill and account collectors, alongside Collection Specialist, Patient Access Specialist and Patient Account Representative. Its task list for that group includes locating and notifying customers of delinquent accounts to solicit payment and arranging repayment schedules based on the customer's financial situation. Résumés carrying those titles have done adjacent work.

Look inside your own walls first. An internal move from payment posting or charge entry keeps institutional knowledge in the building and leaves only the payer-facing half to train.

The external pool has a shape worth knowing. BLS's OEWS survey counted 404,060 billing and posting clerk jobs nationally in May 2025 — the closest group to this desk, counted across all industries. O*NET also places the AR specialist title under bill and account collectors, a group the same BLS survey counted at 158,830 jobs. Two imperfect proxies for one desk is part of why the title wanders between them in postings.

Growth is not the story; churn is. BLS's 2025–35 projections put billing and posting clerks essentially flat, from 418,000 in 2025 to 417,700 in 2035, a change of -0.1%, with about 37,000 openings per year on average. BLS attributes openings of that size in a flat occupation to replacement needs rather than growth. The projections use a different base than the OEWS counts — one that includes the self-employed.

BLS expects billing and posting clerk employment to rise in fast-growing healthcare industries, while automated invoice processing software raises productivity and reduces overall employment growth. Read that as healthcare demand driving the hire and automation reshaping what you hire for.

When you want the stack beyond this role, our guide to hiring billing and coding staff collects the posting, screening and compliance guides for the other billing and coding roles.

Test the work, not the vocabulary. Hand every finalist the same exercise built from your own operation: a de-identified aging report with a handful of claims at different ages, the matching remittance lines, and the escalation policy you actually use. Ask the candidate which claims they would work first and what they would say on each call.

Score for the things the desk lives on. Deadline arithmetic first: a claim approaching the end of Medicare's 1-calendar-year filing limit, and a denial with the 120-day redetermination window closing. Then remittance reading: hand over one 835 payment line and ask the candidate to explain the adjustments aloud. A candidate who reaches for the calendar before the phone is the one you want.

Run the interview the same way every time. OPM describes a structured interview as one in which all candidates get the same predetermined questions in the same order and all responses are rated on the same scale and standards, which it says helps candidates be assessed accurately and consistently.

Keep every exercise job-related. The EEOC says a test an employer requires must be necessary and related to the job and may not exclude people based on protected characteristics. Title VII, the ADA and the ADEA prohibit discriminatory employment tests and selection procedures, and the ADA requires reasonable accommodation in test administration for qualified applicants with disabilities absent undue hardship.

OIG's 1998 compliance guidance for billing companies adds one more step for new employees with discretionary authority over compliance-related decisions: conduct a reasonable and prudent background investigation including a reference check, and require applicants to disclose criminal convictions or exclusion actions. Whether an AR hire carries that discretion — and how far your screening goes — is your call to set.

Score everything against a written rubric, and set productivity and quality expectations as your own standard once the hire is trained. Our research did not confirm any published account-volume or recovery benchmark for this desk worth borrowing — baseline your own operation instead.

OIG exclusion screening. OIG says entities should check the List of Excluded Individuals/Entities before employing or contracting with individuals and periodically afterward, and because OIG updates the LEIE monthly, screening each month best minimizes potential overpayment and civil monetary penalty liability. Anyone who hires an individual or entity on the LEIE may be subject to civil monetary penalties, and OIG says health care entities should routinely check the list for new hires and current employees. OIG's FAQ says the exclusion applies regardless of who submits the claims and applies to all administrative and management services the excluded person furnishes — the category of work this desk does. OIG's General Compliance Program Guidance lists monthly screening of the LEIE and State Medicaid exclusion lists as an example of routine monitoring, and notes that many state Medicaid programs maintain their own exclusion lists. OIG publishes the LEIE as an online searchable database, a downloadable CSV and monthly supplement files. Our guide to screening hires against the OIG exclusion list walks the workflow.

HIPAA training. This desk handles protected health information. The HIPAA Privacy Rule requires a covered entity to train all members of its workforce on its PHI policies and procedures as necessary and appropriate for their functions. New workforce members must be trained within a reasonable period after joining, and the training must be documented; the rule itself sets no fixed annual frequency. The Security Rule separately requires a security awareness and training program for all workforce members including management. HIPAA's definition of workforce reaches employees, volunteers, trainees and other people whose conduct is under the covered entity's or business associate's direct control, so a cross-training temp or an intern counts too.

The desk's own compliance exposure is the calendars. Claims filed after Medicare's 1-calendar-year limit fall outside the filing window, and a redetermination request outside the 120-day window no longer meets Medicare's deadline for that first level of appeal. Write your AR procedures around the dates — aging review cadence, escalation triggers, appeal ticklers — and make the deadlines part of onboarding rather than tribal knowledge.

Rules and dates move. Confirm current requirements with the OIG, HHS and your Medicare Administrative Contractor before you finalize your screening and onboarding steps.

In-house puts the desk next to your charge entry and payment posting staff, which shortens the loop when a follow-up call turns into a corrected claim, and gives you direct control of training and quality. The tradeoff is the full cost of a seat: BLS's Employer Costs for Employee Compensation data put benefits at 30.0% of private-industry compensation costs in June 2026 ($14.07 of $46.89 per hour worked), and at 31.5% for full-time private workers. A wage offer and the true cost of employment are not the same number.

Remote fits the work — remittances, payer portals, phone queues and document trails — and widens the pool past commuting distance. Do the groundwork before the first login: the HIPAA Security Rule's physical safeguards require policies on workstation use and physical safeguards for all workstations that access electronic PHI, which reach home workstations used by remote staff. Define equipment, access controls and a written policy before day one.

Outsourcing AR follow-up to a billing company or RCM vendor moves the work but not the oversight. If a vendor receives and negotiates your Medicare payments, one Medicare rule reaches into the pricing itself. Medicare may pay the billing agent in the provider's name only if the agent's compensation is not related in any way to the dollar amounts billed or collected and is not dependent on actual collection, among other conditions (42 CFR 424.73(b)(3)). CMS's manual says the compensation conditions do not apply if the agent merely prepares bills and does not receive and negotiate the provider's checks — the setup where Medicare payments go to the provider's own account. OIG, separately, has a longstanding concern that percentage-based billing arrangements may increase the risk of upcoding.

Offshore vendors. If a vendor works your accounts offshore, the rules to check are specific rather than blanket. HHS says the HIPAA Rules contain no requirements specific to protected health information handled outside the country. A covered entity or business associate may use a cloud provider that stores ePHI abroad when a business associate agreement is in place, and offshore risks must be considered in the Security Rule risk analysis. The harder federal line sits in Medicaid: states may not make Medicaid payments for items or services to any financial institution or entity located outside the United States. Payer contracts and client agreements can add limits of their own — have health-care counsel read them before you commit.

Whichever model you pick, get pricing in writing against your actual volumes and payer mix before you commit, and run the same LEIE screen on a vendor's staff that you run on your own hires.

Onboard against the deadlines, not just the software. OIG's 2000 compliance guidance for physician practices recommends at least an annual coding and billing training program for everyone involved in coding and billing. It also says new coding and billing staff should be trained as soon as possible and work under an experienced employee until training is complete. Pair your hire with your strongest AR staffer and write the payer-by-payer rules down as you go, so the knowledge survives the next departure.

Measure the desk with your own numbers rather than a borrowed target. HFMA's MAP Keys define the metrics revenue-cycle teams use — Net Days in A/R, for example, is net A/R, net of credit balances, allowances for uncollectible accounts, charity discounts and contractual allowances, divided by average daily net patient service revenue. HFMA supplies the definition, not a target: baseline your own desk by payer mix and set improvement against your own figures.

Give the role a path that does not exit your organization. Cross-train into denial work, payment posting or client reporting, and let the credentials mark the rungs. AAHAM's ladder runs from the Certified Revenue Cycle Specialist toward professional and executive exams for supervisors and managers. HFMA membership includes access to its certifications, most at no additional cost.

Know where your offer stands before the counteroffer conversation. In OEWS May 2025 the closest groups earned a national median of $48,500 for billing and posting clerks and $47,030 for bill and account collectors, both counted across all industries. Treat those as anchors rather than answers — price the desk against your market, your payer mix and what the rest of your billing team earns.

This page is employer information, not coding, billing-compliance, legal or tax advice. Confirm requirements with the agencies and bodies named — the OIG, HHS, CMS and your MAC, and the credential issuers — and with your health-care counsel on contracts and classifications.