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But our mission doesn’t stop with cancer. We're pushing the frontiers of medicine and leading a revolution in healthcare—driven by innovation, compassion, and purpose.
Join us in our mission to improve the human condition across multiple diseases. If you're passionate about meaningful work and want to be part of something bigger than yourself, Caris is where your impact begins.
Position Summary
The Accounts Receivable Specialist is responsible for reviewing and resolving outstanding denied claims with Medicare, Medicaid and Commercial insurance companies. This included following up on claims statuses, researching rejections and denials, handling medical records request and submitting appeals within the timely filing.
Job Responsibilities
Review insurance denials and take appropriate action.
Check claims status via phone or poral.
Submit Medical Records upon request and follow up on submission.
Submit HCFA's claims to insurance companies that do not accept electronic claims.
Submit Retros authorization
Work closely with insurance companies to resolve claims disputes.
Identifying and resolving billing errors and implementing processes to prevent future issues.
Identifying and communicating process improvements to optimize revenue cycle management.
Utilize payor portals to gather claims status information.
Respond promptly and professionally to inquiries from insurance companies, patient, and client's representative with good customer service.
Ensure billing practices comply with HIPAA, CMS guidelines and payor specific policies
Communicate with insurance companies daily.
Must meet or exceed production and quality standards.
Review insurance rejections and make necessary corrections
Prepare and submit appeals with supporting documentation within timely filing.
Submit corrected claims to insurance companies.
Required Qualifications
High School diploma or equivalent required.
2-4 years of experience in a related industry
Strong understanding of Explanation of Benefits (EOBs) to determine denial reasons and appropriate actions.
Excellent communication and interpersonal skills .
Ability to work independently and as part of a team.
Attention to detail and strong organizational skills.
Strong experience using computer software, including medical billing software.
Proficient in Microsoft Office Suite, specifically Word, Excel, Outlook, and general working knowledge of Internet for business use.
Strong Problem-Solving skills with attention to detail.
Strong knowledge of CPT, ICD-10
Ability to adapt to frequent changes and manage tasks efficiently
Preferred Qualifications
Associate's degree accounting, finance, healthcare administration, or a related field OR equivalent combination of education and experience
2+ year's experience in a Medical billing related position, with experience in AR
Must possess professionalism, superior organizational skills, communications skills that allow the ability to educate and influence, an unrelenting passion for persistent follow up, and a drive towards problem resolution.
Overall responsibility will be to follow-up on all claims from billing through final resolution and reduce delinquent accounts to achieve maximum collections from all sources.
Drive for Results (Service, Quality, and Continuous Improvement) - Ensure procedures and processes are in place that will lead to delivery of quality results and continually reassess their effectiveness to achieve continuous improvement.
Communication - Proficient verbal and…