Medical Billing AR Specialist

We are looking for an experienced Insurance Specialist to resolve complex insurance accounts and denials across multiple payer types. In this role, you will act as a subject matter resource for payer regulations, appeals, reimbursement methodologies, and denial prevention, independently handling high-dollar and escalated accounts.

Key Responsibilities
• Manage and resolve complex insurance accounts receivable and aged inventory.
• Analyze and resolve complicated claim denials, underpayments, and reimbursement discrepancies.
• Prepare and submit first-level and advanced payer appeals.
• Serve as a subject matter expert for Medicare, Medicaid, managed care, and commercial payer requirements.
• Identify denial trends, collaborate with cross-functional teams, and support leadership with the onboarding and training of team members.
• Perform other duties as assigned.

Requirements:
• High School Diploma or GED.
• 3 or more years of medical billing, insurance follow-up, or revenue cycle experience.
• Experience with hospital and professional billing, appeals management, and payer contract interpretation.
• Advanced knowledge of insurance billing, reimbursement methodologies, and commercial/government payer regulations.
• Associate degree in Healthcare Administration, Business, or related field.
• Certification such as CPB, CRCR, CPC, or equivalent.
• Experience working with Medicare, Medicaid, and commercial insurance carriers.