Accounts Receivable Specialist – VA/Tricare HB/PB Billing

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 using payer portals and phone communications.

• Confirm coverage and address charge review edits, claim edits, clearinghouse rejections, and payer denials.

• Accurately submit electronic and paper insurance claims.

• Handle non-complex reconsiderations and appeals.

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

• Conduct account follow-up and collections.

• Record collection activities within the billing system.

• Address denied and rejected invoices and prepare payer corrections and appeals.

• Utilize clinical applications, payer websites, and other systems to gather documentation, eligibility details, billing guidelines, referrals, and authorizations.

• Allocate undistributed payments to outstanding balances.

• Examine and resolve correspondence.

• Request adjustments and communicate with patients, insurers, public agencies, internal departments, and third-party payers.

• Rectify insurance setup errors and billing discrepancies.

• Assess credit/balance accounts, issue refunds, and initiate payer recoupments.

• Prepare appeals, adjusted and corrected bills, accounts receivable adjustments, and refunds.

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

• Work collaboratively with Billing, Coding, Cash Posting, and other departments.

• Execute additional responsibilities as assigned.

⛳️ Requirements

• High School Diploma or GED is required.

• Experience with VA/Tricare HB/PB billing is preferred.

• Exceptional written and verbal communication skills.

• High level of confidentiality is essential.

• Capacity to manage a substantial workload.

• Ability to handle multiple tasks simultaneously.

• Capability to manage confidential information in a HIPAA-compliant manner.

• Strong problem-solving and critical thinking abilities.

• Initiative to take on tasks, accept guidance, and seek assistance when necessary.

🏝️ Benefits

• Comprehensive benefits package offered.

• Equal Opportunity Employer commitment.

• Participation in E-Verify.