Insurance Accounts Receivable Specialist I

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

📋 Description

• Execute billing-related responsibilities as assigned, which encompass data entry, claim review, charge review, and follow-up on accounts receivable.

• Concentrate on addressing entry-level insurance denials, particularly those concerning medical records, eligibility, and coordination of benefits (COB).

• Complete daily activities within designated work queues as directed by the manager, following established workflows.

• Leverage CBO Pathways, payer websites, billing systems, and training resources to ascertain the necessary actions for resolving unpaid or underpaid claims and authorizing procedures.

• Detect potential issues related to payer requirements, provider credentialing, or coding, and escalate them to management as necessary.

• Analyze reports to pinpoint unpaid claims and identify potential revenue opportunities.

• Engage in effective communication with providers, patients, coders, and other stakeholders to guarantee accurate and timely claims processing.

• Comply with departmental workflows, operational policies, compliance guidelines, and regulatory standards, including FGP and patient confidentiality protocols.

• Contribute insights on system edits, process enhancements, policies, and billing procedures to facilitate revenue cycle optimization.

• Attend meetings and workgroups, fulfill all mandatory training sessions, and proactively seek additional training when required.

• Read and interpret policies and procedures to make informed decisions, coordinate functions with team members, and clearly explain processes to others.

• Implement system corrections and resubmit claims as necessary to adhere to payer requirements.

• Perform other job-related duties as assigned.

⛳️ Requirements

• High school diploma or equivalent is mandatory.

• Prior experience in a customer service or healthcare environment is preferred.

• Exceptional interpersonal and communication abilities.

• Strong customer service focus and a friendly, approachable attitude.

• Fundamental understanding of medical facility layout and departmental functions (training will be provided).

• Reliability and punctuality are essential.

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

• Cultural sensitivity and the ability to interact respectfully with diverse populations.

• Proficiency in using computer programs and applications, including Microsoft Office.

🏝️ Benefits

• Health insurance

• Dental insurance

• Vision insurance

• Life Insurance

• Pet Insurance

• Health savings account

• Paid sick time

• Paid time off

• Paid holidays

• Profit sharing

• Retirement plan