Healthcare AR Denials & Edits Specialist

CorroHealth, Inc.; United States; Remote; USD 30,000 - 41,000; Full time

Job summary

CorroHealth, Inc. is seeking an AR Specialist to ensure timely collections of government or commercial healthcare receivables. You will follow up on outstanding accounts, verify eligibility, and process denials and appeals with attention to detail and compliance.

The role requires at least 3 years in healthcare AR, active certification, and strong Excel/Outlook/Word skills. You will interact with payers, patients, and providers while maintaining professional communication standards.

Qualifications

• 3+ years of accounts receivable experience within the healthcare revenue cycle.
• Must have an active AAPC or AMHIMA certification.
• 2+ years of experience with healthcare and/or insurance billing and processing.
• Experience with professional physician and hospital facility claims.
• Ability to read and interpret an EOB.
• Knowledge and understanding of UB04 and HCFA 1500 forms.
• High School diploma.
• Proficiency with Outlook, Excel, and Word.
• Must be able to perform basic formulas.
• Strong communication and interpersonal skills.

Responsibilities

• Performs duties as assigned including interacting with insurance plans, patients, physicians, attorneys and team members.
• Assigns accurate codes for inpatient and outpatient physician or hospital-based claims.
• Work denials and appeals by applying edits as needed.
• Verify patient eligibility and/or authorization for services by payer research or calls.
• Update patient demographics and insurance information in systems.
• Research and status unpaid or denied claims.
• Monitor claims for missing information and control numbers.
• Research EOBs for payments or adjustments to resolve claims.
• Contact payers to secure payment of claims.
• Access client systems for information on payments and open claims.
• Follow guidelines for prioritization and deadlines.
• Secure needed medical documentation.
• Obtain billing guidelines by researching manuals.
• Write appeal letters for technical appeals.
• Verify accuracy of underpayments by reviewing contracts and data.
• Prepare claims for clinical audit processing if applicable.

Skills

A/R experience

Healthcare billing

Analytical thinking

Communication skills

Interpersonal skills

Independent work

Education

AAPC or AHIMA certification

High school diploma

Tools

Outlook

Excel

Word

Job description

CorroHealth, Inc. is seeking an AR Specialist to ensure timely collections of government or commercial healthcare receivables. You will follow up on outstanding accounts, verify eligibility, and process denials and appeals with attention to detail and compliance.

The role requires at least 3 years in healthcare AR, active certification, and strong Excel/Outlook/Word skills. You will interact with payers, patients, and providers while maintaining professional communication standards.