Demo

INSURANCE AR SPECIALIST - REMOTE

OrthoAlliance
Cincinnati, OH Remote Contractor
POSTED ON 4/22/2025
AVAILABLE BEFORE 5/22/2025
Posting Details

    • Posted: March 26, 2025
  • Full-Time
  • Remote
  • Locations
Showing 1 location

BOSM Summit OAMSO

Beacon Orthopaedics & Sports Med - Summit Woods

500 E Business Way

Suite A

Cincinnati, OH 45241, USA

BOSM Summit OAMSO

Beacon Orthopaedics & Sports Med - Summit Woods

500 E Business Way

Suite A

Cincinnati, OH 45241, USA

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  • Travel Required: No

Job Details

Description

Position Summary:

Perform the daily collections and management of outstanding accounts, to include following up with insurance companies, reconciling accounts, filing corrected claims, appealing claims (when appropriate), and following up on all denials to ensure processing/reprocessing, and payments. Provide effective customer service for all internal and external customers by using, excellent, in-depth knowledge as well as communicating effectively with team members and strong customer service.

Position Responsibilities/Standards:

General

  • Attend department, clinic or company meetings as required
  • Demonstrate sound judgment by taking appropriate actions regarding questionable findings or concerns
  • Consistently work in a positive and cooperative manner with fellow staff members.
  • Consistently demonstrate ability to respond to changing situations in a flexible manner in order to meet current needs, such as reprioritizing work as necessary.
  • Attend required annual in-service programs.
  • Demonstrate knowledge and understanding of all company policies and procedures. Adheres to established facility safety requirements and procedures to ensure a safe working environment. Identifies potentially unsafe situations and notifies supervisor.

Specific Duties

  • Performs daily on collecting and managing of outstanding accounts, to include following up with insurance companies, reconciling accounts, filing corrected claims, appealing claims (when appropriate), and following up on all denials to ensure processing/reprocessing, and payments.
  • Collaborates with manager and director to report denial trends to ensure proper claim resolution.
  • Collaborates with patients, vendors, and internal departments to resolve conflicts on accounts and resolve any outstanding claims..
  • Ensures accuracy in claims escalation (denials management) while adhering to all regulations.
  • Participates with the team to implement and adhere to policies, procedures, and systems to ensure timely resolution of claims in current Practice Management system.
  • Ensures adherence to objectives, operating policies and procedures, and strategic action plans for achieving goals.
  • Collaborates with manager to create new processes and procedures as needed to improve overall claims escalation process.
  • Performs a variety of administrative duties including, but not limited to: answering phones, faxing and filing
  • Responsible for learning the aspects of compliance in the company by completing all mandatory compliance training.
  • The ability to maintain friendly, cordial relations with fellow coworkers.
  • The ability to build and maintain confidence and credibility with fellow coworkers.
  • The ability to maintain friendly, cordial relations with all clients and employees; maintain a positive work atmosphere by acting and communicating in a manner that results in a positive work relationship with customers, co-workers and managers.
  • The ability to perform the physical, use of senses, cognitive, and environmental functions of the position, as specified on the physical demands.
  • Ability to comply with Company standards of operations.
  • Ability to adhere to the Core Values of the Company, the needs of our patients come first, integrity, trust, personal responsibility, respect and teamwork.
  • The ability to promote and maintain a respectful culture of employee, employer and business confidentiality.
  • Perform other duties as assigned by management.

Education/Experience Required:

  • High School diploma or equivalent
  • Claims Escalation (AR Denials) in a healthcare setting 1-3 years’ experience

Work Environment/Physical Requirements:

Physical requirements for the position include the ability to frequently hear and communicate orally, see up close and at a distance, read and comprehend, stand, sit, walk, reach, handle, and feel objects. Must be able to climb, pull, push and kneel. Maximum unassisted lift = 25 lbs. Average lift less than 10 lbs.

Travel Required

No.

Qualifications

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Preferred

Team Player

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Detail Oriented

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Preferred

Ability to Make an Impact

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High School or better.

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