AR Research & Resolution Representative

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

📋 Description

• Conduct research and address insurance or contract claims to enhance cash collections while reducing denials and lost revenue.

• Manage individual and project-based denial and claim tasks.

• Resolve issues related to claim edits and denials.

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

• Perform insurance or contract follow-up, engage with payers, and communicate with both internal and external business partners via phone and web-based tools.

• Promptly escalate items as necessary.

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

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

• Actively participate in team meetings.

• Stay informed about current government and carrier regulations relevant to the industry.

• Exemplify the organization’s core values.

• Perform and assist with additional departmental duties as required.

⛳️ Requirements

• High school diploma or equivalent.

• Proficient in using personal computers in a Windows environment, with a focus on basic word processing and data entry in spreadsheet programs.

• Understanding of medical insurance and relevant terminology.

• Basic knowledge of ICD-10 and CPT codes.

• Ability to work independently as well as collaboratively within a team.

• Strong attention to detail.

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

• Ability to communicate in a courteous and professional manner.

• Maintain confidentiality effectively.

• Organized approach to processing assigned duties.

• Proficient in basic mathematical calculations, including addition, subtraction, multiplication, and division.

• Ability to thrive in a multi-tasking work environment.

• Willingness to work overtime when necessary.

• Capacity to work efficiently in remote settings.

• Experience in medical insurance, billing, or equivalent training or education is advantageous, though not mandatory.

• Standard office or remote work environment entails prolonged periods of computer use.

• May occasionally involve lifting files or materials weighing up to 15 pounds.

• Visual and manual dexterity is required for computer and claim documentation tasks.

🏝️ 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 and family support benefits.

• Short-term and long-term disability insurance.

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

• Employee assistance programs and wellness resources.

• Eligibility for bonuses, equity, or other incentive programs, depending on the role.