Accounts Receivable Claim Status Specialist - PI/WC
About The Position
This role involves submitting electronic insurance claims, reviewing reports for errors, correcting and resubmitting claims, reconsiderations, and appeals. The specialist will maintain patient ledgers, investigate and process Explanations of Benefits, review accounts receivable reports daily, and follow up on outstanding balances. A key part of the role is conducting timely follow-up on unpaid, underpaid, or denied claims through various communication channels and identifying claim issues such as missing documentation, coding errors, eligibility problems, or authorization discrepancies. All follow-up activities and payer responses must be accurately documented in the billing system.
Requirements
- 2 years’ experience in insurance billing related field preferred
- Proficiency in Microsoft Office
- Excellent verbal and written communication skills
- Strong analytical skills
- Solution oriented
- Ability to multi-task
- Ability to work both individually and as a team
Responsibilities
- Submit electronic insurance claims
- Review electronic reports for errors and correct and resubmit corrected claims, reconsiderations and appeals as necessary
- Maintain patient ledgers in Platinum Patient Accounting Software to reflect accurate and current balances
- Investigate and process Explanations of Benefits from insurance companies
- Review accounts receivable reports on a daily basis; investigate outstanding balances and take the necessary action to facilitate collection of balances due
- Conduct timely follow-up on unpaid, underpaid, or denied claims via payer portals, phone calls, and written correspondence
- Identify claim issues such as missing documentation, coding errors, eligibility problems, or authorization discrepancies
- Document all follow-up activities and payer responses accurately in the billing system
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
