Insurance Accounts Receivable Specialist – II

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

📋 Description

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

• Address intricate insurance denials associated with medical necessity, non-covered services, and bundling issues.

• Handle a higher volume of complex cases while consistently upholding accuracy and productivity standards.

• Complete daily tasks in assigned work queues following managerial guidance and established procedures.

• Utilize CBO Pathways, payer websites, billing systems, and training materials to resolve unpaid or incorrectly compensated claims and to authorize procedures.

• Detect and escalate issues related to payers, provider credentialing inconsistencies, and coding problems.

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

• Adhere to departmental processes, organizational policies, regulatory mandates, compliance, and confidentiality standards.

• Interact with providers, patients, coders, and other stakeholders to facilitate efficient claim processing.

• Offer insights and suggestions regarding system modifications, billing procedures, policies, and protocols.

• Participate in training sessions, meetings, and workgroups; escalate concerns as necessary.

• Uphold patient confidentiality and consistently apply relevant policies and procedures.

• Collaborate with colleagues and clarify processes and procedures when required.

• Make system adjustments and resubmit claims in accordance with payer specifications.

• Carry out additional duties related to the position as assigned.

• Comply with ethical standards, relevant laws, the Solaris Health Code of Conduct, HIPAA, reporting obligations, and annual compliance training requirements.

⛳️ Requirements

• A high school diploma or equivalent is mandatory.

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

• Exceptional written and verbal communication abilities.

• Capability to articulate billing concerns clearly.

• Familiarity with insurance policies, types of denials, and medical terminology.

• Proficient in task prioritization, effective time management, and achieving performance targets.

• Proven problem-solving abilities and a commitment to resolving account issues.

• Competence in computer applications and programs, particularly Microsoft Office.

• Ability to adhere to payer guidelines, workflows, organizational policies, regulatory standards, compliance protocols, and confidentiality requirements.

• Capacity to maintain patient confidentiality in accordance with HIPAA regulations.

🏝️ Benefits

• Competitive salary

• Paid time off (PTO)

• Holiday compensation

• Health insurance coverage

• Dental insurance options

• Vision insurance plans

• Life insurance

• Pet insurance

• Health savings account

• Paid sick leave

• Paid time off

• Paid holidays

• Profit-sharing opportunities

• Retirement savings plan

• No weekend shifts

• No evening hours

• No holiday work