AR Claim Status Specialist

TVG-Medulla, LLC•Oak Brook, IL

3d•$20 - $22

About The Position

We are seeking an Accounts Receivable (A/R) Claims Specialist to join our Revenue Cycle team. In this role, you’ll help keep our revenue cycle moving by managing insurance claims from submission through resolution. You’ll investigate unpaid and denied claims, work directly with insurance payers, resolve discrepancies, and ensure patient accounts accurately reflect current balances and payment activity. This is an opportunity to play an important role in the financial health of a growing healthcare organization while developing your expertise in medical claims, insurance follow-up, denials, appeals, and revenue cycle management. If you’re detail-oriented, persistent, and enjoy figuring out why a claim hasn’t paid and what needs to happen next, this could be a great fit.

Requirements

2 years’ experience in insurance billing & collections related field preferred
Previous experience in medical billing, insurance claims, accounts receivable, or revenue cycle management strongly preferred
Working knowledge of insurance claim submission, denials, appeals, EOBs, and payer follow-up
Experience navigating insurance payer portals and communicating directly with insurance companies
Understanding of healthcare reimbursement and A/R aging preferred
Strong investigative and problem-solving skills with the ability to determine the root cause of unpaid or denied claims
High attention to detail and accuracy when reviewing patient accounts and claim information
Strong organizational and time-management skills with the ability to manage a high-volume claim workload
Clear written and verbal communication skills
Comfortable learning and working within multiple billing systems and payer platforms
Experience with Micrsoft Office

Nice To Haves

Experience with Platinum Patient Accounting Software is a plus, but not required

Responsibilities

Submit electronic insurance claims accurately and within established filing requirements
Review electronic claim reports for errors and correct and resubmit rejected claims
Conduct timely follow-up on unpaid, underpaid, rejected, and denied claims through payer portals, phone calls, and written correspondence
Prepare and submit claim reconsiderations, corrected claims, and appeals when appropriate
Review and process Explanations of Benefits (EOBs) and payer responses
Investigate outstanding accounts receivable balances and take appropriate action to facilitate payment
Review A/R reports regularly to identify aging claims, payment delays, denials, and other outstanding balances requiring follow-up
Research claim issues including missing documentation, coding or billing errors, eligibility concerns, authorization discrepancies, and payer requirements
Maintain patient ledgers in Platinum Patient Accounting Software to ensure balances and account activity are accurate and current
Document all claim follow-up activity, payer correspondence, status updates, and next steps clearly within the billing system
Escalate recurring payer issues or complex claims when additional review is needed
Collaborate with internal billing, clinic, and revenue cycle team members to obtain information needed for claim resolution
Help identify trends contributing to denials or delayed reimbursement and support efforts to improve clean-claim and collection performance