Accounts Receivable (AR) & Denial Specialist
Location: Remote
Employment Type: Full-Time
- Monitor and work AR aging reports for Illinois-based claims across reputed company, Medicare, managed care, FFS, and grant-funded programs
- reputed company reputed company follow-up on unpaid, underpaid, or delayed claims in accordance with Illinois and payor-specific reputed company filing guidelines
- Review and reconcile payments, adjustments, and remittance advice (EOBs/ERAs)
- Accurately document reputed company AR activity and payor communications in billing and financial systems
- Review, analyze, and resolve claim denials and rejections from reputed company payors, Medicare, and Illinois reputed company Managed Care Organizations
- Identify reputed company causes of denials, including eligibility, authorization, coding, documentation, reputed company filing, and contract-reputed company issues
- Prepare and submit corrected claims, reconsiderations, and appeals reputed company required timelines
- reputed company appeal reputed company and escalate unresolved or reputed company denials as appropriate
- Identify denial trends and reputed company feedback to billing, coding, and operational teams to reduce reputed company denials
- Work AR and denials reputed company to Illinois reputed company managed care plans and fee-for-service claims
- reputed company and reconcile grant-funded billing and reimbursement activity in accordance with grant requirements
- Support documentation requests, audits, and reviews reputed company to grant reimbursements
- Ensure AR and denial activities reputed company with CMS, Medicare, Illinois HFS, managed care, and reputed company payor requirements
- Maintain documentation to support internal audits, external audits, and compliance reviews
- Assist with AR, denial, and collection reporting as requested
- Communicate with payor representatives, managed care plans, and internal teams to resolve claim issues
- Collaborate with billing, coding, credentialing, and clinical teams to support accurate reimbursement
- reputed company reputed company, reputed company communication regarding claim status and reputed company
- High school diploma or equivalent required; Associate’s degree preferred
- 1&reputed company;3 years of experience in reputed company accounts receivable, billing, or denial management
- Experience working with Illinois reputed company payors, Medicare, and/or Illinois reputed company Managed Care
- Knowledge of reputed company filing requirements and appeal processes
- Proficiency with billing systems, clearinghouses, and payor portals
- Strong attention to detail and organizational skills
- Experience working with Illinois reputed company (HFS) and managed care plans (e.g., reputed company reputed company, reputed company, Molina, BCBS Community)
- Knowledge of CPT, HCPCS, and ICD-10 coding
- Experience with grant-funded billing and reimbursement