AR Follow-up Specialist

Responsibilities:
-Follow up on unpaid or denied medical claims with insurance companies via phone calls, portals, or emails.
-Analyze Explanation of Benefits (EOBs) and remittance advice to determine denial reasons and required corrective actions.
-Resolve claim denials, rejections, or underpayments by submitting appeals or corrected claims.
-Document all actions taken on accounts in the billing system.
-Collaborate with billing team, coding, and providers to resolve claim issues.

Required Skills:
-Graduate of any 4year college degree
-Must have 2+ years in a Healthcare BPO setting
-Knowledge of commercial, HMO, Medicare/Medicaid, and other payer requirements.
-Working knowledge on the use of insurance payer websites ie: Availity, Optum, Medicare, Evicore portals.
-Working knowledge with Practice Management systems, preferably KAREO a plus.
-Effective communication abilities with and not limited to team members outside clients and patients.
-Proven problem-solving skills. The ability to research and resolve complex insurance denials while obtaining a clear understanding to present actionable solutions.
-Proficient knowledge of medical terminology is likely to be encountered in medical claims denials.

Additional Notes:
-This position will be working with global business solutions company specializing in Environmental Risk & Compliance, Sustainability & ESG, and Business Process & Impact Sourcing.
-Working Set-up: Onsite
-Mondays to Fridays.