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Revenue Cycle Specialist II - AR & Denials Follow-Up

E.N.T. Specialty Partners
🇺🇸 United States
Remote
Manager or above
1 week ago
  • 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

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