Job Description:
• Perform follow up on unpaid and underpaid insurance claims and review claim status through payer portals, IVR systems and clearinghouses
• Manage work queue and meet productivity expectations
• Independently resolve denials including medical necessity, authorization, coding, payer policy disputes, and timely filing exceptions
• Execute formal appeals , including medical record review, narrative development, and payer escalation
• Analyze remittance to identify underpayments, takebacks, and payer trends
• Manage and maintain detailed records of all receivable transactions, including invoices, statements, and customer correspondence
• Monitor account details for non-payments, delayed payments, and other irregularities
• Comply with federal, state, and company policies, procedures, and regulations
• Perform day-to-day financial transactions, including verifying, classifying, and recording accounts receivable data
Requirements:
• High School Diploma or GED required, Associate’s or Bachelor’s degree in health information management or related field preferred.
• Proven work experience in healthcare AR, Billing or revenue cycle
• Basic understanding of healthcare revenue cycle
• Strong attention to detail and willingness to learn payer rules
• Ability to follow structured processes and workflows
• Experience with appeals and denials resolution
Benefits:
• Additional benefits and perks may also be available, depending on the position and employment terms.