Strategic AR Denials & Appeals Specialist

Southeastern Medical Oncology Center (SMOC); Goldsboro (NC); Presencial; USD 42.000 - 64.000; Jornada completa

Descripción de la vacante

SMOC is seeking a Denials & Accounts Receivable Specialist to research and resolve insurance denials, manage outstanding AR, process payments, and file appeals when needed. You will collaborate with patients, carriers, and internal departments to ensure accurate reimbursement and complete documentation.

The role focuses on denial management, AR follow-up, and support across the revenue cycle.

Formación

• 1 year experience in medical billing, insurance denials, or accounts receivable preferred.
• Working knowledge of medical billing, insurance reimbursement, claim denials, and appeals.
• Ability to research billing issues and maintain accurate account documentation.

Responsabilidades

• Review and research insurance claim denials to determine the cause of nonpayment.
• Identify billing or claim errors and correct or resubmit claims when appropriate.
• Prepare and submit insurance appeals with supporting documentation as required.
• Maintain accurate documentation of denial activity and resolution efforts.
• Review assigned accounts receivable and address outstanding insurance balances.
• Research unpaid claims, underpayments, and payment discrepancies to determine appropriate resolution.
• Communicate with insurance carriers to resolve billing issues and obtain necessary claim information.
• Maintain accurate account notes and collection documentation.
• Post insurance payments accurately to patient accounts.
• Review payment information to identify discrepancies and ensure proper account application.
• Research and resolve payment posting issues and other insurance-related account discrepancies.
• Assist patients with billing questions, copay inquiries, and account-related concerns as needed.
• Provide backup insurance verification support as needed.
• Send requested medical records to insurance companies and other authorized parties to support claims, appeals, and payment resolution.
• Work with internal departments to obtain information necessary to resolve billing issues.
• Assist with additional billing and revenue cycle duties as assigned.

Conocimientos

Attention to detail

Communication skills

Analytical skills

Organization

Billing knowledge

Educación

High school diploma or equivalent

Herramientas

Billing software

Descripción del empleo

SMOC is seeking a Denials & Accounts Receivable Specialist to research and resolve insurance denials, manage outstanding AR, process payments, and file appeals when needed. You will collaborate with patients, carriers, and internal departments to ensure accurate reimbursement and complete documentation.

The role focuses on denial management, AR follow-up, and support across the revenue cycle.