AR Specialist - Clinical Denials

Job Summary

To ensure timely collection of outstanding healthcare insurance receivables, the full-time AR Specialist - Clinical Denials will verify eligibility, research unpaid claims, and communicate with payers while working remotely.

Key responsibilities

• Verify and obtain eligibility and authorization through various systems and communication with insurance providers
• Research and status unpaid or denied claims, monitoring for missing information and necessary documentation
• Contact payers to secure payment for claims and submit reconsiderations and appeals as needed

Required qualifications

• 2-3 years of experience in medical collections, denials, and appeals
• Intermediate knowledge of ICD-10, CPT, HCPCS, and NCCI coding
• Familiarity with billing claim forms (UB04/1500) and third-party billing guidelines
• Proficient in Microsoft Word and Excel
• Experience with health information systems such as EMR and Patient Accounting Systems