AR Specialist - Clinical Denials

Job Summary

To ensure timely collection of outstanding healthcare insurance receivables, the full-time AR Specialist - Clinical Denials will work remotely, verifying eligibility, researching unpaid claims, and managing communications with payers.

Key responsibilities

• Verify eligibility and authorization using various systems and direct communication with insurance carriers
• Research and status unpaid or denied claims, ensuring compliance with state and federal guidelines
• Contact payers to secure payment of claims and manage reconsideration and appeal submissions

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 third-party billing guidelines and billing claim forms (UB04/1500)
• Proficiency in Microsoft Word and Excel
• Experience with health information systems such as EMR and Patient Accounting Systems