Insurance Accounts Receivable Specialist

Job Description:

• Perform billing-related tasks as assigned, including data entry, claim review, charge review, and accounts receivable follow-up
• Focus on resolving entry-level insurance denials, such as those related to medical records, eligibility, and coordination of benefits (COB)
• Complete daily tasks within assigned work queues based on manager direction and established workflows
• Utilize CBO Pathways, payer websites, billing systems, and training materials to determine appropriate actions for resolving unpaid or underpaid claims and authorizing procedures
• Identify potential issues related to payer requirements, provider credentialing, or coding, and escalate to management as appropriate
• Review reports to identify unpaid claims and potential revenue opportunities
• Communicate effectively with providers, patients, coders, and other stakeholders to ensure accurate and timely claims processing
• Adhere to departmental workflows, operational policies, compliance guidelines, and regulatory requirements, including FGP and patient confidentiality standards
• Provide input on system edits, process improvements, policies, and billing procedures to support revenue cycle optimization
• Participate in meetings and workgroups, complete all required training sessions, and actively seek additional training when needed
• Read and apply policies and procedures to make informed decisions, coordinate functions with team members, and explain processes clearly to others
• Make system corrections and resubmit claims as necessary to meet payer requirements
• Performs other position related duties as assigned

Requirements:

• High school diploma or equivalent required
• Previous experience in a customer service or healthcare setting preferred
• Excellent interpersonal and communication skills
• Strong customer service orientation and a friendly, approachable demeanor
• Basic knowledge of medical facility layout and department functions (training provided)
• Dependability and punctuality
• Ability to work independently and as part of a team
• Cultural sensitivity and ability to interact respectfully with diverse populations
• Skill 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

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