INSURANCE AR SPECIALIST - REMOTE

Central Indiana Orthopedics PC; Cincinnati (OH); Remote; USD 35,000 - 55,000; Full time

Job summary

An established industry player is seeking a diligent Accounts Receivable Specialist to manage daily collections and outstanding accounts. In this pivotal role, you will follow up with insurance companies, reconcile accounts, and ensure effective claim processing. The ideal candidate will possess strong attention to detail and exceptional customer service skills, working collaboratively with internal teams to resolve conflicts and improve processes. Join a supportive environment that values integrity, teamwork, and the well-being of patients, and make a meaningful impact in the healthcare sector.

Qualifications

• High School diploma required with 1-3 years in healthcare claims escalation.
• Detail-oriented with strong customer service skills.

Responsibilities

• Manage outstanding accounts and follow up with insurance companies.
• Collaborate to resolve conflicts on accounts and ensure timely claim resolution.

Skills

Claims Escalation

Customer Service

Detail Oriented

Team Player

Education

High School diploma or equivalent

1-3 years experience in healthcare claims escalation

Job description

BOSM Summit OAMSO
Beacon Orthopaedics & Sports Med - Summit Woods
500 E Business Way
Suite A
Cincinnati, OH 45241, USA

Perform the daily collections and management of outstanding accounts, to include following up with insurance companies, reconciling accounts, filing corrected claims, appealing claims (when appropriate), and following up on all denials to ensure processing/reprocessing, and payments. Provide effective customer service for all internal and external customers by using excellent, in-depth knowledge as well as communicating effectively with team members and strong customer service.

Position Responsibilities/Standards:

General

• Attend department, clinic or company meetings as required
• Demonstrate sound judgment by taking appropriate actions regarding questionable findings or concerns
• Consistently work in a positive and cooperative manner with fellow staff members.
• Consistently demonstrate ability to respond to changing situations in a flexible manner in order to meet current needs, such as reprioritizing work as necessary.
• Attend required annual in-service programs.
• Demonstrate knowledge and understanding of all company policies and procedures. Adhere to established facility safety requirements and procedures to ensure a safe working environment. Identify potentially unsafe situations and notify supervisor.

Specific Duties

• Perform daily collections and management of outstanding accounts, including following up with insurance companies, reconciling accounts, filing corrected claims, appealing claims (when appropriate), and following up on all denials to ensure processing/reprocessing and payments.
• Collaborate with manager and director to report denial trends to ensure proper claim resolution.
• Collaborate with patients, vendors, and internal departments to resolve conflicts on accounts and resolve any outstanding claims.
• Ensure accuracy in claims escalation (denials management) while adhering to all regulations.
• Participate with the team to implement and adhere to policies, procedures, and systems to ensure timely resolution of claims in current Practice Management system.
• Ensure adherence to objectives, operating policies and procedures, and strategic action plans for achieving goals.
• Collaborate with manager to create new processes and procedures as needed to improve overall claims escalation process.
• Perform a variety of administrative duties including, but not limited to: answering phones, faxing, and filing.
• Responsible for learning the aspects of compliance in the company by completing all mandatory compliance training.
• Maintain friendly, cordial relations with fellow coworkers and clients; maintain a positive work atmosphere by acting and communicating in a manner that results in a positive work relationship with customers, co-workers, and managers.
• Comply with Company standards of operations and adhere to the Core Values of the Company, putting the needs of our patients first, integrity, trust, personal responsibility, respect, and teamwork.
• Promote and maintain a respectful culture of employee, employer, and business confidentiality.
• Perform other duties as assigned by management.

Education/Experience Required:

• High School diploma or equivalent
• Claims Escalation (AR Denials) in a healthcare setting 1-3 years’ experience

Work Environment/Physical Requirements:

Physical requirements for the position include the ability to frequently hear and communicate orally, see up close and at a distance, read and comprehend, stand, sit, walk, reach, handle, and feel objects. Must be able to climb, pull, push, and kneel. Maximum unassisted lift = 25 lbs. Average lift less than 10 lbs.

Travel Required:

No.

Qualifications

Skills

Behaviors

Preferred

Team Player

Works well as a member of a group

Detail Oriented

Capable of carrying out a given task with all details necessary to get the task done well

Motivations

Preferred

Ability to Make an Impact

Inspired to perform well by the ability to contribute to the success of a project or the organization