Insurance AR Specialist: Claims & Collections

Carle Health; Normal (IL); On-site; USD 24,000 - 39,000; Full time

Job summary

Carle Health is seeking an Accounts Receivables Insurance Specialist 1 to manage insurance receivables and ensure claims are processed accurately in line with payer rules and billing guidelines.

The role involves collecting on outstanding balances, resolving denials, preparing appeals, and coordinating with Billing, Coding, and other departments to optimize payment outcomes across community, government, and commercial plans.

Responsibilities

• Take initiative but also accept direction and seek guidance appropriately.
• Maintain confidentiality with HIPAA-compliant handling of information.
• Submit timely and accurate claims to health insurance carriers for community, government and commercial plans.
• Analyze accounts to determine next actions for resolution and document collection activities.
• Prepare payer corrections and/or appeals per payer requirements via electronic or paper processes.
• Assist callers and direct them to the appropriate representative to resolve issues.
• Review undistributed payments and apply them to open balances; resolve balance discrepancies.

Job description

Carle Health is seeking an Accounts Receivables Insurance Specialist 1 to manage insurance receivables and ensure claims are processed accurately in line with payer rules and billing guidelines.

The role involves collecting on outstanding balances, resolving denials, preparing appeals, and coordinating with Billing, Coding, and other departments to optimize payment outcomes across community, government, and commercial plans.