Accounts Receivable Insurance Specialist, Denials

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Oversee accounts receivable in accordance with compliance, regulatory, billing, and payer standards

• Retrieve outstanding receivables through payer portals and phone communications

• Confirm coverage and accurately process insurance claims

• Address charge review edits, claim amendments, clearinghouse denials, and payer rejections

• Follow up on overdue receivables and handle basic appeals

• Respond to, document, and finalize inquiries from insurance companies, internal teams, patients, public agencies, and third-party payers

• Monitor, investigate, and resolve claims that are unpaid, rejected, denied, or have allowance discrepancies

• Record collection activities within the billing system

• Prepare payer corrections, revised bills, appeals, refunds, account modifications, and payer recoupments

• Analyze undistributed payments and allocate them to outstanding balances

• Review and address incoming correspondence

• Collaborate with Billing, Coding, Cash Posting, and other departments to ensure claims are processed and compensated accurately

• Respond to department calls through a rotation line and direct callers accordingly

• Execute additional tasks as assigned

⛳️ Requirements

• Demonstrated ability to take initiative, accept guidance, and seek assistance appropriately

• Capacity to manage confidential information with care and discretion in compliance with HIPAA regulations

• Strong problem-solving abilities and critical thinking skills

• Proficiency in submitting accurate electronic and paper insurance claims

• Capability to submit straightforward reconsiderations and appeals through paper, fax, or web portals

• Expertise in monitoring, researching, and resolving claims that are unpaid, rejected, denied, or have allowance discrepancies

• Skill in analyzing accounts and determining suitable account-resolution actions

• Ability to utilize clinical applications, payer websites, and other systems for medical documentation, eligibility information, billing guidelines, referrals, and procedure-code authorizations

• Competence in resolving insurance setup errors, charge review edits, claim edits, clearinghouse rejections, and payer rejections

• Capacity to evaluate credit/balance accounts and initiate refunds or payer recoupments

• Certifications, education, and work experience are not delineated

🏝️ Benefits

• Comprehensive benefits package

• Flexible schedule available after training