Insurance Accounts Receivable Specialist I

GENERAL SUMMARY

The Insurance Accounts Receivable Specialist I is responsible for performing entry-level insurance billing and follow-up tasks to support timely and accurate reimbursement. This includes submitting claims, reviewing basic denials, and conducting follow-up on outstanding balances under supervision.

Requirements

• Perform billing-related tasks as assigned, including data entry, claim review, charge review, and accounts receivable follow-up.
• Focus on resolving entry-level insurance denials, such as those related to medical records, eligibility, and coordination of benefits (COB).
• Complete daily tasks within assigned work queues based on manager direction and established workflows.
• Utilize CBO Pathways, payer websites, billing systems, and training materials to determine appropriate actions for resolving unpaid or underpaid claims and authorizing procedures.
• Identify potential issues related to payer requirements, provider credentialing, or coding, and escalate to management as appropriate.
• Review reports to identify unpaid claims and potential revenue opportunities.
• Communicate effectively with providers, patients, coders, and other stakeholders to ensure accurate and timely claims processing.
• Adhere to departmental workflows, operational policies, compliance guidelines, and regulatory requirements, including FGP and patient confidentiality standards.
• Provide input on system edits, process improvements, policies, and billing procedures to support revenue cycle optimization.
• Participate in meetings and workgroups, complete all required training sessions, and actively seek additional training when needed.
• Read and apply policies and procedures to make informed decisions, coordinate functions with team members, and explain processes clearly to others.
• Make system corrections and resubmit claims as necessary to meet payer requirements.

Skills

• Excellent interpersonal and communication skills.
• Strong customer service orientation and a friendly, approachable demeanor.
• Basic knowledge of medical facility layout and department functions (training provided).
• Dependability and punctuality.
• Ability to work independently and as part of a team.
• Cultural sensitivity and ability to interact respectfully with diverse populations.
• Skill in using computer programs and applications including Microsoft Office.

Benefits

• Health insurance
• Dental insurance
• Vision insurance
• Life Insurance
• Pet Insurance
• Health savings account
• Paid sick time
• Paid time off
• Paid holidays
• Profit sharing
• Retailer plan