The A/R Claims Specialist is a full‐time hourly position responsible for expediting the proper adjudication of insurance claims and any potential candidate must have a zeal for resolving A/R denials. Primary responsibilities include but are not limited to: researching and resubmitting unpaid medical claims, working with insurance carriers and patients to obtain payment, updating patient insurance and demographic information, submitting appeals and reconsiderations to payers, and contacting client offices to procure pertinent patient information. This role requires undivided attention to detail, a commitment to accuracy and thoroughness, and the ability to work large claim volumes by strategizing and identifying trends.

Role and Responsibilities

• Manage accurate and timely insurance claims follow-up and accounts receivable resolution for assigned payers
• Accountable for complex payers, aged claims, and special accounts receivable projects
• Adhere to government regulations, payer contracts, and insurance guidelines when performing insurance follow-up, resolving open accounts, and appealing claims
• Act as key contributor to the Revenue Cycle by identifying and reporting inefficiencies and opportunities that enhance revenue flow, decrease denials, and minimize write-offs
• Manages insurance and patient correspondence
• Contacts insurance carriers, patients, and/or other facilities as needed to ensure maximum
• payment is realized
• Reports trending claims denials with supporting documentation to Management Team
• Answers inbound patient calls and collects and post payments received while providing
• impeccable customer service support
• Participates in trainings / meetings with payers and internal departments to address trends in denials or unprocessed claims
• Additional duties as assigned by your supervisor

Qualifications and Education Requirements

• Minimum of 3 years A/R follow up experience
• Proficient in using Microsoft Office software
• Excellent navigation and keyboarding skills (45+ wpm)
• Exceptional organizational, communication and interpersonal skills with ability to Independently perform tasks of a routine nature
• Ability to manage multiple priorities
• Outstanding verbal and written communication skills
• Excellent attention to detail and accuracy
• Ability to consistently deliver quality work during allotted timeframes
• Understands and ensures compliance with our Data Protection policies and procedures
• Valid driver’s license/car insurance with ability to travel to business office as needed