AR Research and Resolution Representative

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

📋 Description

• Investigate and resolve pending insurance or contract claims to optimize cash collections while minimizing denials and lost revenue.

• Handle individual and project-specific denial and claim assignments.

• Address claim edits and denials effectively.

• Keep worklists and assignments at acceptable levels in accordance with performance targets, KPIs, and quality scores.

• Conduct follow-ups on insurance or contract matters, involving communication with payers and liaising with both internal and external business partners via phone and web-based tools.

• Promptly escalate issues as needed.

• Identify opportunities for enhancing department workflows and cross-functional processes.

• Contribute to the development of company-wide payer matrices and uphold Standard Operating Procedures.

• Actively engage in team meetings.

• Maintain an understanding of current government and carrier regulations pertinent to the industry.

• Exemplify the organization's core values.

• Perform and assist with additional departmental duties as required.

⛳️ Requirements

• High school diploma or equivalent qualification.

• Experience in medical insurance or billing, or relevant training or education, is advantageous but not mandatory.

• Familiarity with personal computers in a Windows environment.

• Basic skills in word processing and spreadsheet data entry.

• Understanding of medical insurance and terminology.

• Fundamental knowledge of ICD-10 and CPT codes.

• Ability to work autonomously while contributing effectively to a team.

• Strong attention to detail.

• Capability to identify, research, and resolve issues and discrepancies.

• Professional and courteous communication skills.

• Ability to maintain confidentiality.

• Organized approach to processing assigned tasks.

• Proficient in performing basic mathematical calculations.

• Competence in working effectively in a multitasking environment.

• Willingness to work overtime when necessary.

• Capability to function effectively in remote settings.

🏝️ Benefits

• Options for medical, dental, and vision insurance.

• Health savings accounts (HSA) and flexible spending accounts (FSA).

• 401(k) contributions from both employees and employers.

• Paid time off, which includes vacation, sick leave, and company holidays.

• Paid parental leave along with family support benefits.

• Short-term and long-term disability insurance coverage.

• Life and accidental death & dismemberment (AD&D) insurance.

• Employee assistance programs and wellness resources.

• Additional compensation may include eligibility for bonuses, equity, or other incentive programs, depending on the role.