Accounts Receivable Insurance Specialist- Must have Eligibility and Registration experience

This is a Fully Remote Job
About Our Client:
The organization operates within the healthcare industry, providing patient care through multiple hospitals and a multispecialty provider group across central and southeastern Illinois. It addresses challenges in healthcare delivery and professional development by integrating patient services with educational initiatives such as an engineering-based medical school. The organization maintains recognized nursing excellence through Magnet designations and offers career growth opportunities in various communities.
About the Opportunity:
The ACCOUNTS RECEIVABLE INSURANCE SPECIALIST role focuses on managing accounts receivable following compliance, regulatory, and billing guidelines specific to various payers. The position is responsible for ensuring accurate insurance claim billing, resolving claim and charge issues, and collecting outstanding receivables. This role is critical in facilitating timely payment processes and supporting the financial operations that underpin effective healthcare delivery.
Responsibilities:
Manage accounts receivable in accordance with compliance and payer-specific rules.
Collect outstanding receivables via payer portals and phone communication.
Validate insurance coverage and resolve charge review and claim edits.
Follow up on unpaid claims and complete basic appeals.
Respond to inquiries from insurance companies, internal departments, and third-party payers.
Collaborate with Billing, Coding, Cash Posting, and other departments to ensure accurate claim processing.
Submit claims and appeals timely and accurately for community, government, and commercial health plans.
Monitor and resolve unpaid, rejected, or denied claims.
Analyze accounts to determine appropriate collection actions.
Document collection activities thoroughly in the billing system.
Prepare payer corrections and appeals following plan requirements.
Use clinical applications and payer websites to retrieve necessary documentation and information.
Review and apply undistributed payments to open balances.
Identify and request appropriate account adjustments.
Resolve insurance setup errors and billing rejections.
Evaluate accounts in discrepancy status and prepare appeals for reimbursement.
Prepare adjusted and corrected bills or refunds as needed.
Assist with department calls and direct inquiries appropriately.
Perform additional duties as assigned.
Requirements:
Ability to take initiative and seek guidance appropriately.
Manage confidential information with sensitivity and in compliance with HIPAA.
Strong problem-solving and critical thinking skills.
Pay Range and Compensation Package:
The pay range for this position is $17.26 per hour to $27.96 per hour.
Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Note:
TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.

Skills
Patient Care, Documentation

Work arrangement
Yes