AR Claims Specialist I: Drive Payment Resolutions

TriCore Reference Laboratories; Albuquerque (NM); On-site; USD 25,000 - 33,000; Full time

Job summary

TriCore Reference Laboratories seeks a Claims Specialist I to manage accounts receivable for patient accounts, commercial and government payers. The role requires routine follow-up, appeals, and reporting using XIFIN and Excel, with a focus on aged and unresolved accounts.

The position operates Monday–Friday with shifts as needed at the Journal Center location, and adherence to immunization requirements and office policies is expected.

Qualifications

• Proficient in PC/data entry and basic software tools.
• Knowledge of Excel and Word.

Responsibilities

• Collects outstanding accounts receivable on patient accounts from various payers via phone, mail, or appeals.
• Pursues collection activities through resubmission, appeals, or reconsideration until resolution.
• Works reports to identify aged receivables and unresolved accounts.
• Researches adjustments and gathers backup to support adjustments.
• Uses online resources to obtain current information from insurers.
• Maintains professional relations with internal and external customers and insurer representatives.
• Creates reports in XIFIN and Excel to prioritize accounts for collection.

Skills

PC/data entry skills

Excel

Word

Education

High school diploma or equivalent

Apprentice training program

Job description

TriCore Reference Laboratories seeks a Claims Specialist I to manage accounts receivable for patient accounts, commercial and government payers. The role requires routine follow-up, appeals, and reporting using XIFIN and Excel, with a focus on aged and unresolved accounts.

The position operates Monday–Friday with shifts as needed at the Journal Center location, and adherence to immunization requirements and office policies is expected.