Insurance Accounts Receivable Specialist
Job Description:
- Perform billing-related tasks as assigned, including data entry, claim review, charge review, and accounts receivable follow-up
- Focus on resolving entry-level insurance denials, such as those related to medical records, eligibility, and coordination of benefits (COB)
- Complete daily tasks within assigned work queues based on manager direction and established workflows
- Utilize CBO Pathways, payer websites, billing systems, and training materials to determine appropriate actions for resolving unpaid or underpaid claims and authorizing procedures
- Identify potential issues related to payer requirements, provider credentialing, or coding, and escalate to management as appropriate
- Review reports to identify unpaid claims and potential revenue opportunities
- Communicate effectively with providers, patients, coders, and other stakeholders to ensure accurate and timely claims processing
- Adhere to departmental workflows, operational policies, compliance guidelines, and regulatory requirements, including FGP and patient confidentiality standards
- Provide input on system edits, process improvements, policies, and billing procedures to support revenue cycle optimization
- Participate in meetings and workgroups, complete all required training sessions, and actively seek additional training when needed
- Read and apply policies and procedures to make informed decisions, coordinate functions with team members, and explain processes clearly to others
- Make system corrections and resubmit claims as necessary to meet payer requirements
- Performs other position related duties as assigned
Requirements:
- High school diploma or equivalent required
- Previous experience in a customer service or healthcare setting preferred
- Excellent interpersonal and communication skills
- Strong customer service orientation and a friendly, approachable demeanor
- Basic knowledge of medical facility layout and department functions (training provided)
- Dependability and punctuality
- Ability to work independently and as part of a team
- Cultural sensitivity and ability to interact respectfully with diverse populations
- Skill in using computer programs and applications including Microsoft Office
Benefits:
- Health insurance
- Dental insurance
- Vision insurance
- Life Insurance
- Pet Insurance
- Health savings account
- Paid sick time
- Paid time off
- Paid holidays
- Profit sharing
- Retirement plan
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