Revenue Cycle Specialist II - AR & Denials Follow-Up
- EHR
- HIPAA
- Health insurance
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*THIS IS A REMOTE POSITION*
Insurance AR Follow-Up Specialist
This position is responsible for managing and performinginsurance accounts receivable (AR) follow-up, including claim status review, denials, reconsiderations, appeals, and resolution of outstanding insurance balances. The ideal candidate will have a strong understanding of the insurance billing and reimbursement process and be able to independently identify and resolve claim issues.
Primary Responsibilities:
- Perform timely and thoroughinsurance AR follow-up on outstanding claims and balances.
- Monitor claim status and contact insurance carriers to resolve unpaid, underpaid, and denied claims.
- Research and workdenials, reconsiderations, appeals, and payer requests for additional information or medical records.
- Identify the root cause of claim denials and determine the appropriate resolution, including corrected claims, reconsiderations, appeals, or additional documentation.
- Review claim history, payments, adjustments, charges, and account activity within the EHR to ensure accurate account resolution.
- Review and interpret insurance correspondence, Explanation of Benefits (EOBs), remittance information, and payer responses.
- Coordinate with providers and internal departments when additional information, documentation, coding clarification, or other action is required to resolve a claim.
- Maintain accurate and detailed documentation of all AR follow-up activity and payer communications.
- Follow HIPAA requirements when handling patient information and providing or requesting medical records.
- Accurately enter and maintain account and claim information within the computer system.
- Work assigned AR inventory according to established priorities, productivity expectations, and follow-up timeframes.
- Respond to account-related correspondence and payer inquiries in a timely manner.
- Provide professional and respectful customer service to patients and their families when assistance is needed regarding insurance balances.
- Work effectively both independently and as part of a team to meet departmental goals.
- Maintain confidentiality of patient and company information.
- Perform other related duties as assigned.
The ability to independently work insurance AR, denials, reconsiderations, and appeals is a key expectation of this position. Candidates should have a demonstrated foundation of at least 3–5 years of experience in these areas.
Qualifications
Required Experience:
- Minimum of 3–5 years of hands-on experience in medical insurance AR follow-up.
- Demonstrated experience withinsurance claim follow-up, denials, reconsiderations, and appeals.
- Strong understanding of insurance payer requirements, claim processing, timely filing, authorizations, eligibility, coding-related denials, medical records requests, and other common reimbursement issues.
- Experience researching unpaid and denied claims, determining the appropriate next action, and documenting follow-up activity accurately.
- Ability to work independently and manage a high-volume AR workload while meeting established productivity and quality expectations.
Revenue Cycle Specialist II - AR & Denials Follow-Up · E.N.T. Specialty Partners