Insurance Receivables Specialist — Claims & Collections

Carle Health; Champaign (IL); On-site; USD 36,000 - 58,000; Full time

Job summary

Carle Health in Champaign, IL seeks an Accounts Receivables Insurance Specialist 1 to manage and optimize insurance billing and receivables across community, government and commercial plans. You will validate coverage, handle edits, and follow up on open items with payers and internal teams to ensure timely payments.

The role emphasizes accuracy, issue resolution, and collaboration with Billing, Coding, Cash Posting, and other departments to ensure compliant and efficient claims processing.

Responsibilities

• Timely and accurate submissions of claims to health insurance carriers (electronic and paper billing).
• Submit non-complex reconsiderations/appeals to carriers via paper, fax or web portal.
• Monitor and resolve unpaid/denied/adjustment claims.
• Follow up and collect on assigned accounts.
• Analyze accounts and determine next action for resolution.
• Document pertinent collection activities in the billing system.
• Resolve denied/rejected invoices per payer requirements.
• Use payer portals and systems to substantiate corrected claims submissions.
• Review undistributed payments for application to open balances.
• Identify and request adjustments.
• Respond to inquiries from patients, insurance companies, public agencies, internal departments and third-party payers.

Job description

Carle Health in Champaign, IL seeks an Accounts Receivables Insurance Specialist 1 to manage and optimize insurance billing and receivables across community, government and commercial plans. You will validate coverage, handle edits, and follow up on open items with payers and internal teams to ensure timely payments.

The role emphasizes accuracy, issue resolution, and collaboration with Billing, Coding, Cash Posting, and other departments to ensure compliant and efficient claims processing.