Accounts Receivable Insurance Specialist – Hospital Billing, Medicaid, Denials, Dual Systems Experience

🔥 3 hours ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $17 - $27 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

💰 Accounts Receivable

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

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 • Submit timely claims and non-complex reconsiderations or appeals for community, government, and commercial health plans • Monitor, research, and resolve unpaid, rejected, denied, and allowance-discrepancy claims • Document collection activities in the billing system • Retrieve medical documentation, eligibility information, billing guidelines, referrals, and authorizations using clinical applications and payer websites • Apply undistributed payments to open balances • Review and resolve incoming correspondence • Identify, prepare, and request account adjustments • Resolve insurance setup errors to facilitate timely billing • Evaluate credit/balance accounts and initiate refunds or payer recoupments • Prepare adjusted and corrected bills, accounts-receivable adjustments, and payer appeals • Answer or direct departmental calls through a rotation line • Perform other duties as assigned • Collaborate with Billing, Coding, Cash Posting, and other departments to ensure claims are processed and paid correctly

🎯 Requirements

• Must have Hospital Billing, Medicaid, Denials and Dual Systems experience • Ability to take initiative, accept direction, and seek guidance appropriately • Ability to manage confidential information with sensitivity and discretion 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 • Ability to monitor, research, and resolve unpaid, rejected, denied, and allowance discrepancy claims • Ability to analyze accounts and determine appropriate account-resolution actions • Knowledge of payer plan requirements, billing guidelines, and health insurance processes • Ability to use clinical applications, payer websites, billing systems, clearinghouses, and other research systems • Ability to resolve insurance setup errors, charge review edits, claim edits, and payer or clearinghouse rejections • Ability to evaluate credit/balance accounts, refunds, payer recoupments, and allowance discrepancies • Ability to document collection activities accurately and thoroughly • Ability to respond to patients, insurance companies, public agencies, internal departments, and third-party payers • Qualifications list no specific certification, education, or work-experience minimum

🏖️ Benefits

• Comprehensive benefits package • Day shift schedule, Monday-Friday 8am-5pm • No weekend requirements • No holiday requirements • No on-call requirements