Accounts Receivable Specialist – Hospital Billing, Epic Experience

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 utilizing payer portals and telephone communication.

• Verify coverage and accurately file insurance claims.

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

• Follow up on overdue receivables and manage basic appeals.

• Handle, document, and resolve inquiries from insurance companies, internal teams, patients, public agencies, and third-party payers.

• Work collaboratively with Billing, Coding, Cash Posting, and other departments to ensure accurate processing and payment of claims.

• Investigate and resolve unpaid, rejected, denied, and allowance-discrepancy claims.

• Record collection activities in the billing system.

• Gather necessary medical documentation, eligibility data, billing protocols, referrals, and authorizations.

• Review unallocated payments and apply them to outstanding balances.

• Examine and address incoming correspondence.

• Identify and request adjustments to accounts.

• Rectify insurance setup issues.

• Assess credit/balance accounts and process refunds or payer recoupments.

• Prepare corrections for payers, appeals, adjusted and corrected invoices, accounts-receivable adjustments, and refunds.

• Respond to departmental calls through a rotation line and direct callers as needed.

• Perform additional duties as required.

⛳️ Requirements

• Hospital billing experience is essential.

• Familiarity with Epic systems is required.

• Capacity to take initiative, receive direction, and seek guidance when necessary.

• Ability to manage confidential information sensitively and in compliance with HIPAA regulations.

• Strong problem-solving and analytical skills.

• Experience in submitting both electronic and paper claims to health insurance providers.

• Proficiency in submitting non-complex reconsiderations and/or appeals via paper, fax, or web portal.

• Skill in monitoring, researching, and resolving unpaid, rejected, denied, and allowance-discrepancy claims.

• Capability to analyze accounts and determine suitable resolution actions.

• Proficient in using clinical applications, payer websites, and other platforms to research medical documentation, eligibility information, billing guidelines, referrals, and authorizations.

• Ability to rectify insurance setup errors, charge-review edits, claim edits, clearinghouse rejections, and payer refusals.

• Competence in evaluating credit/balance accounts, issuing refunds, and initiating payer recoupments.

• Skill in preparing appeals, corrected invoices, accounts-receivable adjustments, and refunds.

• No specific certification, education, or work experience requirements listed.

🏝️ Benefits

• Comprehensive benefits package available.

• Equal Opportunity Employer.

• Participation in E-Verify program.