Healthcare Accounts Receivable Specialist
About The Position
The Healthcare Accounts Receivable Specialist is responsible for persistently following up on submitted insurance claims to ensure timely payment. This role focuses on monitoring claim status, proactively contacting insurance payers to push claims toward payment, and identifying issues that prevent payment. When issues are identified, the Specialist escalates findings to the Manager, Healthcare Accounts Receivable for resolution. The Healthcare Accounts Receivable Specialist will respond to internal and external medical customer inquiries related to claims in a timely manner. The role will work collaboratively with the other AbleNet staff to provide a continuous improvement of the medical claims collection process.
Requirements
- Detailed oriented, organized, and self-starter
- Ability to work in a team environment and independently as required.
- Proficient with computer skills-computer programs, spreadsheets, and applications
- Excellent communication skills in verbal and writing
- Familiarity with insurance claim workflows and payer adjudication timelines
- Experience communicating with insurance payers via phone, EMR and online portals
- Knowledge of traditional insurance plans, HMO/PPO’s, Medicare, and Medicaid
- Bachelor’s degree preferred or equivalent work experience
- 5+ Years of experience in claims follow up work experience
Responsibilities
- Proactively contact insurance payers via phone, portals, and written communication to check claim according to the framework outlined by leadership
- “Nudge” or persistently follow up with payers on delayed, pending, or stalled claims to drive payment forward
- Escalate identified claim issues to the Manager, Healthcare Accounts Receivable for investigation and resolution
- Clearly document payer feedback, claim status updates, and identified issues in internal systems
- Track claim aging and prioritize follow-up based on established timelines and payment targets
- Ensure all follow-up activity is completed in accordance with payer requirements and internal workflows
- Maintain awareness of payer turnaround times and escalation thresholds
- Adhere to all practice policies related to HIPAA and Medicare Compliance
- Contributes to the overall operations and to the achievement of departmental goals
- Perform backup support for other members of the team department.
- Effective communication with patients, insurance companies, and healthcare providers
- Embrace AbleNet’s culture and 7 rules of engagement
- All other duties as assigned
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
