Insurance Specialist I - Corporate Patient AR Management - Full Time
for section headings (e.g., About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). We must not repeat job title as heading. We must include sections only when posting has real, specific content. Must not create Pay/Schedule/Benefits unless posting actually states them. The posting includes "Schedule & Coverage:" with "Full Time, Day Shift". That's schedule info. Also benefits: bullet list under "Why Choose Guthrie:" includes voluntary 403(b), Employee Assistance Program, PTO starts Day 1, Friendly inclusive work family. Also "Recognized as a Top Healthcare Employer:" bullet list of awards. Also "About Guthrie Towanda Hospital:" paragraph.
We need to map to allowed headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule.
We can have sections: About the role (maybe combine About Guthrie Towanda Hospital and Why Choose Guthrie and Recognized as a Top Healthcare Employer). Responsibilities (Position Summary + Essential Functions + Other Duties). Requirements (Education, License & Cert + Experience). Qualifications maybe same as Requirements? But we can decide to have Requirements and Qualifications separate if content distinct. However we have Education/License/Cert and Experience; could put under Requirements. Skills maybe from "Strong organizational and customer service skills a must. Experience with office software such as Word and Excel required." That's skills. Could put under Skills.
Benefits: we have benefits list.
Schedule: we have Schedule & Coverage: Full Time, Day Shift.
Pay: not mentioned, so omit.
We must not create sections with filler text. Ensure each heading has substantive content.
We need to use - for any list of duties/requirements/benefits, and
for prose.
We need to preserve all substantive information; do not invent or summarize away detail. So we need to include all details from the posting, but we can group them.
We must remove boilerplate: cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions. There's none.
We need to output only HTML fragment.
Let's structure:
About the role
Build a rewarding career at the intersection of healthcare, customer service, and problem-solving. As an Insurance Specialist I, you'll gain valuable industry knowledge while helping patients and care teams navigate the complexities of insurance and healthcare coverage.
At Guthrie Towanda Hospital, you’ll find more than just a job — Our 68-bed facility offers the intimacy of a small team with the backing of a nationally recognized health system.
Why Choose Guthrie:
- Voluntary 403(b) Retirement Plan – Plan for your future with Fidelity investment options
- Employee Assistance Program – Confidential support for personal and professional well-being
- PTO starts Day 1
- Friendly, Inclusive Work Family – Be part of a team that feels like home
Recognized as a Top Healthcare Employer: Guthrie is consistently recognized for its strong workplace culture and commitment to caregiver well‑being, including:
- Best Places to Work 2025
- Modern Healthcare
- America's Greatest Workplaces in Healthcare 2025, 2026
- Newsweek - America's Best-In-State Employers (PA) 2025
- Forbes - America's Best Employers for Healthcare Professionals 2025
- Forbes - America's Best Employers for Women 2025
But note: The bullet list under "Recognized as a Top Healthcare Employer:" includes some items that are not bullet points originally? Actually original:
- Best Places to Work 2025
- Modern Healthcare
- America's Greatest Workplaces in Healthcare 2025, 2026
- Newsweek - America's Best-In-State Employers (PA) 2025
- Forbes - America's Best Employers for Healthcare Professionals 2025
- Forbes - America's Best Employers for Women 2025
We'll keep as list.
Now Responsibilities section:
Responsibilities
Position Summary: Responsible for non‐complex electronic and paper claim submissions to insurance payers. Coordinates required information for filing secondary and tertiary claims reviews and analyzes claims for accuracy, i.e. diagnosis and procedure codes are compatible and accurate. Makes charge corrections or follows up with appropriate parties as needed to ensure billing invoice is correct. Follows up with payers on unresponded claims. Works denied claims by following correct coding and payer guidelines resulting in appeal or charge correction. Teams with Insurance Billing Specialist II and Denial Resolution staff to work projects, request guidance on more complex billing issues and cross training for other payers and tasks. Responds to a variety of questions from insurance companies, government agencies and all Guthrie Medical Group offices. Partners with CRC and other Guthrie departments to field billing inquiries. Answers all correspondence from insurance carriers including requests for supportive documentation.
Essential Functions:
- Works pre‐AR edits, paper claims, reports and work queues as assigned to ensure accurate and timely claim submission to individual payers. Reports possible payer or submission issues.
- Works closely with a Denial Resolution Specialist or Billing Specialist II mentor to cross train on various payers and tasks to expand insurance billing knowledge and skills.
- Follows up on rejected and/or non‑responded claims as assigned. Utilizes internal rejection protocols, coding knowledge, reimbursement policies, payer guidelines and other sources in order to research rejections to secure appropriate payment.
- Provides back up to Central Charge Entry and Cash Applications. Manually enters charges, posts and distributes insurance and patient payments.
- Promptly reports payer, system or billing issues.
- Utilizes Epic system functions accurately to perform assigned tasks. Ex: charge corrections, invoice inquiry, billing edits, insurance eligibility.
- Exports and prepares spreadsheets, manipulating data fields for project work.
- Identifies and provides appropriate follow up for claims that require correction or appeal.
- Provides timely resolution of credit balance as identified and/or assigned.
- Requests adjustments on invoices that have been thoroughly researched and/or were unable to reach payment resolution. Documents support on request forms and performs adjustments within policy guidelines.
Other Duties:
- Provides feedback related to workflow processes in order to promote efficiency.
- Answers phone calls and correspondence providing request information. Documents action taken and provides appropriate follow up.
- Acquires and maintains knowledge of and performs within the compliance of the Guthrie Clinic’s Corporate Revenue Cycle policies and insurance payer regulations and guidelines.
- Demonstrates excellent customer service skills for both internal and external customers.
- Maintains strict confidentiality related to patient health information in accordance with HIPAA regulations.
- Assists with and completes projects and other duties as assigned.
Now Requirements section:
Requirements
Education, License & Cert: High school diploma required; CPC, CCA, RHIA, RHIT certification in medical billing and coding or Associates degree preferred.
Experience: Strong organizational and customer service skills a must. Experience with office software such as Word and Excel required. Previous experience performing in a high volume and fast paced environment.
Now Skills section maybe separate:
Skills
Strong organizational and customer service skills. Proficiency with office software (Word, Excel). Ability to work in high volume, fast‑paced environment.
But we already included experience with Word/Excel in Requirements; maybe we can combine. However we need to avoid duplication. The instruction: Preserve ALL substantive information; do NOT invent or summarize away detail. If we put skills separate, we might duplicate content. Better to keep Requirements include education, license, cert, experience, and maybe skills. But we have a separate Skills heading allowed; we could put skills there and not duplicate. However the experience bullet includes "Strong organizational and customer service skills a must." That's a skill. Also "Experience with office software such as Word and Excel required." That's also skill. So we could put those under Skills and keep Experience just about previous experience in high volume fast paced environment. But the posting says "Experience: Strong organizational and customer service skills a must. Experience with office software such as Word and Excel required. Previous experience performing in a high volume and fast paced environment." So we could split: Skills: Strong organizational and customer service skills; Proficiency with Word and Excel. Experience: Previous experience performing in a high volume and fast paced environment. Education, License & Cert: as before.
Thus we need sections: Requirements (Education, License & Cert) maybe separate? But we have headings: Requirements, Qualifications, Skills. We could use Requirements for Education, License & Cert. Qualifications for Experience? Or we could combine. Let's decide:
- Requirements: Education, License & Cert.
- Qualifications: Experience (previous experience in high volume fast paced environment).
- Skills: Strong organizational and customer service skills; Proficiency with Word and Excel.
That avoids duplication and uses all three headings.
Now Benefits section:
Benefits
- Voluntary 403(b) Retirement Plan – Plan for your future with Fidelity investment options
- Employee Assistance Program – Confidential support for personal and professional well-being
- PTO starts Day 1
- Friendly, Inclusive Work Family – Be part of a team that feels like home
But we also have the "Recognized as a Top Healthcare Employer:" list; that could be considered part of Benefits? It's more about awards/recognition. Could be under Benefits or maybe under About the role. Since we already used About the role for intro and hospital description, we could add a subsection under About the role for recognition. But we already used About the role for intro and hospital description; we could add a paragraph about recognition there. However we have a separate Benefits heading; we could put the recognition list under Benefits as well, but it's not a benefit per se. The instruction: include a section ONLY when the posting has real, specific content for it. The posting has recognition content; we could put it under About the role as a paragraph. But we already used About the role for intro and hospital description; we can extend it.
Thus About the role section will contain:
- Intro paragraph (Build a rewarding career...)
- About Guthrie Towanda Hospital paragraph
- Why Choose Guthrie bullet list (benefits)
- Recognized as a Top Healthcare Employer bullet list
But then we would have Benefits section duplicate. Better to move benefits to Benefits section and keep About the role for intro and hospital description only. Then we need to place the "Why Choose Guthrie:" bullet list (benefits) under Benefits. And the "Recognized as a Top Healthcare Employer:" list could be under About the role as a paragraph about awards, or we could create a separate section like "Recognition" but not allowed headings. So we can put it under About the role as a paragraph.
Thus:
for prose. We need to preserve all substantive information; do not invent or summarize away detail. So we need to include all details from the posting, but we can group them. We must remove boilerplate: cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions. There's none. We need to output only HTML fragment. Let's structure:
About the role
Build a rewarding career at the intersection of healthcare, customer service, and problem-solving. As an Insurance Specialist I, you'll gain valuable industry knowledge while helping patients and care teams navigate the complexities of insurance and healthcare coverage.
At Guthrie Towanda Hospital, you’ll find more than just a job — Our 68-bed facility offers the intimacy of a small team with the backing of a nationally recognized health system.
Why Choose Guthrie:
- Voluntary 403(b) Retirement Plan – Plan for your future with Fidelity investment options
- Employee Assistance Program – Confidential support for personal and professional well-being
- PTO starts Day 1
- Friendly, Inclusive Work Family – Be part of a team that feels like home
Recognized as a Top Healthcare Employer: Guthrie is consistently recognized for its strong workplace culture and commitment to caregiver well‑being, including:
- Best Places to Work 2025
- Modern Healthcare
- America's Greatest Workplaces in Healthcare 2025, 2026
- Newsweek - America's Best-In-State Employers (PA) 2025
- Forbes - America's Best Employers for Healthcare Professionals 2025
- Forbes - America's Best Employers for Women 2025
Responsibilities
Position Summary: Responsible for non‐complex electronic and paper claim submissions to insurance payers. Coordinates required information for filing secondary and tertiary claims reviews and analyzes claims for accuracy, i.e. diagnosis and procedure codes are compatible and accurate. Makes charge corrections or follows up with appropriate parties as needed to ensure billing invoice is correct. Follows up with payers on unresponded claims. Works denied claims by following correct coding and payer guidelines resulting in appeal or charge correction. Teams with Insurance Billing Specialist II and Denial Resolution staff to work projects, request guidance on more complex billing issues and cross training for other payers and tasks. Responds to a variety of questions from insurance companies, government agencies and all Guthrie Medical Group offices. Partners with CRC and other Guthrie departments to field billing inquiries. Answers all correspondence from insurance carriers including requests for supportive documentation.
Essential Functions:
- Works pre‐AR edits, paper claims, reports and work queues as assigned to ensure accurate and timely claim submission to individual payers. Reports possible payer or submission issues.
- Works closely with a Denial Resolution Specialist or Billing Specialist II mentor to cross train on various payers and tasks to expand insurance billing knowledge and skills.
- Follows up on rejected and/or non‑responded claims as assigned. Utilizes internal rejection protocols, coding knowledge, reimbursement policies, payer guidelines and other sources in order to research rejections to secure appropriate payment.
- Provides back up to Central Charge Entry and Cash Applications. Manually enters charges, posts and distributes insurance and patient payments.
- Promptly reports payer, system or billing issues.
- Utilizes Epic system functions accurately to perform assigned tasks. Ex: charge corrections, invoice inquiry, billing edits, insurance eligibility.
- Exports and prepares spreadsheets, manipulating data fields for project work.
- Identifies and provides appropriate follow up for claims that require correction or appeal.
- Provides timely resolution of credit balance as identified and/or assigned.
- Requests adjustments on invoices that have been thoroughly researched and/or were unable to reach payment resolution. Documents support on request forms and performs adjustments within policy guidelines.
Other Duties:
- Provides feedback related to workflow processes in order to promote efficiency.
- Answers phone calls and correspondence providing request information. Documents action taken and provides appropriate follow up.
- Acquires and maintains knowledge of and performs within the compliance of the Guthrie Clinic’s Corporate Revenue Cycle policies and insurance payer regulations and guidelines.
- Demonstrates excellent customer service skills for both internal and external customers.
- Maintains strict confidentiality related to patient health information in accordance with HIPAA regulations.
- Assists with and completes projects and other duties as assigned.
Requirements
Education, License & Cert: High school diploma required; CPC, CCA, RHIA, RHIT certification in medical billing and coding or Associates degree preferred.
Experience: Strong organizational and customer service skills a must. Experience with office software such as Word and Excel required. Previous experience performing in a high volume and fast paced environment.
Now Skills section maybe separate:Skills
Strong organizational and customer service skills. Proficiency with office software (Word, Excel). Ability to work in high volume, fast‑paced environment.
But we already included experience with Word/Excel in Requirements; maybe we can combine. However we need to avoid duplication. The instruction: Preserve ALL substantive information; do NOT invent or summarize away detail. If we put skills separate, we might duplicate content. Better to keep Requirements include education, license, cert, experience, and maybe skills. But we have a separate Skills heading allowed; we could put skills there and not duplicate. However the experience bullet includes "Strong organizational and customer service skills a must." That's a skill. Also "Experience with office software such as Word and Excel required." That's also skill. So we could put those under Skills and keep Experience just about previous experience in high volume fast paced environment. But the posting says "Experience: Strong organizational and customer service skills a must. Experience with office software such as Word and Excel required. Previous experience performing in a high volume and fast paced environment." So we could split: Skills: Strong organizational and customer service skills; Proficiency with Word and Excel. Experience: Previous experience performing in a high volume and fast paced environment. Education, License & Cert: as before. Thus we need sections: Requirements (Education, License & Cert) maybe separate? But we have headings: Requirements, Qualifications, Skills. We could use Requirements for Education, License & Cert. Qualifications for Experience? Or we could combine. Let's decide: - Requirements: Education, License & Cert. - Qualifications: Experience (previous experience in high volume fast paced environment). - Skills: Strong organizational and customer service skills; Proficiency with Word and Excel. That avoids duplication and uses all three headings. Now Benefits section:Benefits
- Voluntary 403(b) Retirement Plan – Plan for your future with Fidelity investment options
- Employee Assistance Program – Confidential support for personal and professional well-being
- PTO starts Day 1
- Friendly, Inclusive Work Family – Be part of a team that feels like home