Healthcare Accounts Receivable
Resolution Specialist – Level 1
Job Summary
As a Healthcare Accounts Receivable (AR) Resolution Specialist – Level 1, you will play a key role in ensuring timely reimbursement by managing denied or unpaid claims. This entry-level position involves researching and resolving billing issues, following up with payers, and maintaining accurate documentation. You will collaborate with the revenue cycle management team to optimize AR performance and support the financial stability of healthcare clients.
Key Responsibilities
- Review and resolve unpaid or denied claims from payers within designated timeframes.
- Research and address claim denial reasons, including coding errors, missing documentation, or eligibility issues.
- Resubmit corrected claims and ensure all follow-up actions are completed.
- Maintain detailed and accurate records of claim statuses, resolution actions, and payer communications.
- Communicate with payers, providers, and internal teams to address outstanding issues.
- Monitor AR aging reports and prioritize high-value claims for resolution.
- Ensure compliance with payer policies, state regulations, and HIPAA guidelines.
Qualifications
- High school diploma or equivalent (Bachelor’s degree preferred).
- Basic knowledge of medical billing, coding, and payer guidelines (training provided for entry-level candidates).
- Strong communication and problem-solving skills.
- Proficiency in Microsoft Office and familiarity with medical billing software.
- Ability to prioritize tasks and meet deadlines in a fast-paced environment.
