Requirements
Responsibilities:
Make outbound calls to insurance companies to inquire about the status of claims.
Identify and resolve claim denials, exceptions, or exclusions.
Read and interpret insurance Explanation of Benefits (EOBs).
Maintain accurate and detailed notes regarding collection efforts.
Follow up on unpaid claims within standard billing cycle timeframes.
Investigate and appeal denied claims.
Handle patient inquiries on account status and charges.
Maintain strict confidentiality in accordance with HIPAA regulations and company policy.
Work with the billing team to ensure all bills have been dispatched to the relevant parties.
Stay informed about changes in insurance policies, procedures, and regulations.
Qualifications:
High School Diploma or equivalent; further education in a related field will be a plus.
Previous experience in AR calling is preferred, but not mandatory.
Strong knowledge of medical insurance (HMO, PPO, Medicare, Medicaid, etc.).
Understanding of medical terminology, ICD-10, CPT, and HCPCS coding.
Proficient in MS Office and data entry, experience with medical software preferred.
Excellent communication, negotiation, and problem-solving skills.
Attention to detail and ability to analyze insurance EOBs.
Ability to maintain professionalism and a positive service attitude at all times.
Willingness to stay up-to-date with healthcare laws and regulations.
Respect for patient confidentiality and adherence to HIPAA guidelines.
Ability to work independently and manage time efficiently.