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Form of workJob Description
Title: Full-Time AR Insurance Specialist (Remote Position)
Department: CBO
Reports To: Manager
FLSA Status: Non-Exempt
JOB REQUIREMENTS
- Ability to read, comprehend, and decipher explanations of benefits (EOBs) from various insurance carriers.
- Working knowledge of medical terminologies, such as CPT and ICD10 codes.
- Strong background in claims processing and filing insurance appeals and disputes.
- The primary point of contact with health insurance providers/systems and healthcare clients/systems.
- Ability to utilize payer’s websites/portals to determine insurance guidelines, claim status, or eligibility criteria.
- Experienced in authorization denials and follow-ups.
- Ability to utilize multiple systems/platforms to conduct research and analysis.
JOB SPECIFICATIONS
- A high school diploma or equivalent is required.
- Prior relevant work experience in AR/Medicaid/Commercial health insurance processes.
- Demonstrated customer service experience and/or experience in a customer service-oriented environment.
- Strong customer service orientation with demonstrated commitment to meet/exceed customer needs.
- Ability to maintain reliable and predictable attendance.
- Strong verbal/written communication and interpersonal skills.
- Demonstrated ability to work in a fast-paced, structured environment, handling large call volumes.
- Computer proficiency is essential.
- Self-directed with the ability to perform both as part of a team and individually.
- Ability to adapt and work effectively in a continuously changing environment.
- Consistently demonstrate a high level of professionalism through a strong work ethic that positively influences the work habits of the team.
- Detail-oriented with a focus on quality and consistently meeting goals.
QUALIFICATIONS
To perform this job successfully the incumbent must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
EDUCATION and/or EXPERIENCE
A high school diploma is required; Medical Coding degree/certificate or an Associate degree is preferred. Two to three years of related experience and/or training; or an equivalent combination of education and experience.
LANGUAGE SKILLS
The position requires the ability to read and comprehend basic instructions, general correspondence, and memos. In addition, the ability to write office correspondence, effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization are required.
MATHEMATICAL SKILLS
Ability to add, subtract, multiply and divide into all units of measure, using whole numbers, common fractions, and decimals.
REASONING ABILITY
The incumbent will be expected to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Also, should have the ability to deal with problems involving several concrete variables in standardized situations. Will be expected to learn and comprehend basic physician billing/AR management terminology and protocols to effectively function within the position’s scope of responsibilities.
