Accounts Receivable Insurance Specialist – Eligibility and Registration

🔥 0 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $17 - $27 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

💰 Accounts Receivable

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This company has sponsored H1B visas in the past.

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Carle Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1946

⚕️ Healthcare Insurance

🏥 Healthcare

📚 Education

Healthcare Insurance • Healthcare • Education

Carle Health is a comprehensive healthcare provider dedicated to managing the health needs of its community. Offering a wide range of services, from general medical care to specialized treatments in oncology, cardiovascular, pediatrics, and women's health, Carle Health emphasizes quality patient care and community health initiatives. Additionally, it supports education and research through the Carle Illinois College of Medicine and engages in community health programs that aim to improve overall well-being.

📋 Description

• Manage accounts receivable in accordance with compliance, regulatory, billing, and payer guidelines • Collect outstanding receivables through payer portals and phone lines • Validate coverage and accurately bill insurance claims • Resolve charge review edits, claim edits, clearinghouse rejections, and payer rejections • Follow up on outstanding receivables and complete basic appeals • Answer, document, and complete inquiries from insurance companies, internal departments, and third-party payers • Collaborate with Billing, Coding, Cash Posting, and other departments to ensure claims are processed and paid correctly • Submit timely and accurate claims for community, government, and commercial health plans • Submit reconsiderations and appeals for assigned health insurance carriers • Research and resolve unpaid, rejected, denied, and allowance-discrepancy claims • Document collection activities accurately in the billing system • Retrieve medical documentation, patient eligibility information, billing guidelines, referrals, and authorizations using clinical applications and payer websites • Apply undistributed payments to open balances as applicable • Review and resolve incoming correspondence • Identify, prepare, and request account adjustments • Respond to patient, insurance company, public agency, internal department, and third-party payer inquiries • Evaluate allowance discrepancies and prepare payer appeals, corrected bills, accounts receivable adjustments, or refunds • Answer departmental calls on a rotating line and direct callers as needed • Perform other duties as assigned

🎯 Requirements

• Eligibility and Registration experience required (as stated in the title) • Ability to take initiative while accepting direction and seeking guidance appropriately • Ability to manage confidential information sensitively and discreetly in a HIPAA-compliant way • Strong problem-solving and critical thinking skills • Ability to submit accurate electronic and paper insurance claims • Ability to submit non-complex reconsiderations and appeals via paper, fax, or web portal • Ability to monitor, research, and resolve unpaid, rejected, denied, and allowance-discrepancy claims • Ability to analyze accounts and determine appropriate account-resolution actions • Ability to use clinical applications, payer websites, and other systems to research medical documentation, eligibility information, billing guidelines, referrals, and authorizations • Ability to resolve insurance setup errors, charge review edits, claim edits, clearinghouse rejections, and payer rejections • Ability to evaluate credit/balance accounts and process refunds or payer recoupments • Ability to prepare appeals, adjusted/corrected bills, accounts receivable adjustments, and refunds according to procedures

🏖️ Benefits

• Comprehensive benefits package • Equal Opportunity Employer • E-Verify participation

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