Insurance AR Specialist -Remote -TX Resident

ORTHOLONESTAR•Houston, TX

91d•Remote

About The Position

The Insurance AR Specialist is responsible for reviewing and submitting claims daily and maintaining accurate, timely accounts receivable reconciliation. The role works insurance claims and correspondence, follows up on outstanding balances, resolves billing issues, and supports timely payment and appropriate claim resolution. The position is remote for a Texas resident; the listed work environment is a climate-controlled office in a cubicle setting. The role has no supervisory responsibilities. The employee must maintain confidentiality and comply with HIPAA guidelines and regulations, manage and prioritize assigned work, participate in educational activities, and report payer issues or delays to a supervisor.

Requirements

High school diploma or GED.
At least one year of experience in medical billing or collections.
Ability to read and write.
Ability to add, subtract, multiply, and divide using whole numbers, common fractions, and decimals.
Ability to read and interpret explanation of benefits remittances to identify claim denial reasons and determine appropriate resolution steps.
Typing speed of 45 words per minute.
Basic proficiency in Microsoft Outlook and Office.
Experience using, or ability to learn and understand, computer programs.
Ability to perform the essential duties satisfactorily, manage assigned workload, and prioritize accordingly.

Responsibilities

Prepare and submit clean claims to insurance companies electronically or on paper.
Contact insurance carriers by phone or website to obtain status updates on outstanding insurance balances.
Process insurance correspondence.
Perform collection activities, including contacting patients and correcting and resubmitting claims to other carriers.
Obtain documentation needed to submit claims to insurance and expedite payments.
Answer questions from patients, clerical staff, and insurance companies.
Identify and resolve patient billing complaints.
Prepare appeal letters for claims denied for payment.
Document collection activities according to established guidelines.
Identify underpayments by comparing payments received with the contracted fee schedule.
Work and process insurance refund requests.
Report payer issues or delays to a supervisor.
Participate in educational activities.
Maintain confidentiality and adhere to HIPAA guidelines and regulations.
Manage and prioritize assigned workload and recommend solutions to problems.
Maintain accurate and timely accounts receivable reconciliation.
Review claims stopped in the claim scrubber.
Work claims rejected by the clearinghouse.