Insurance Collections and AR Agent

Job description:

Key Responsibilities: Insurance Collections & AR Follow-Up

• Review aging reports to identify unpaid or underpaid claims.
• Contact insurance companies via phone, portal, or written correspondence to resolve outstanding claims.
• Follow up on denied or rejected claims and take corrective action (appeals, resubmissions, corrections).
• Track claim status until full payment is received.
• Escalate complex claims to supervisors when necessary.

Patient Collections

• Reach out to patients regarding outstanding balances in a professional and empathetic manner.
• Set up payment arrangements or explain billing statements.
• Document patient communications and payment commitments.

Denial Management

• Investigate reasons for claim denials or partial payments.
• Correct claim errors and resubmit timely.
• File appeals with insurance carriers as needed.
• Collaborate with the billing/coding team to prevent recurring denials.

Documentation & Reporting

• Maintain accurate and detailed notes of all collection activities.
• Update patient accounts and AR records in the billing system.
• Generate and review AR and collection reports for management.
• Meet monthly collection goals and performance metrics.

Compliance & Customer Service

• Ensure all collection activities comply with HIPAA and healthcare regulations.
• Maintain professionalism and confidentiality in patient/insurance interactions.
• Provide excellent customer service to patients and insurance representatives.

Skills & Qualifications

• Knowledge of medical billing, coding (ICD-10, CPT, HCPCS), and insurance guidelines.
• Experience with claim follow-up, AR management, and denial resolution.
• Strong communication and negotiation skills.
• Ability to analyze EOBs (Explanation of Benefits) and remittance advice.
• Proficiency with billing software and electronic health record (EHR) systems.
• Attention to detail, persistence, and time management skills.

Performance Metrics (KPIs)

• AR days outstanding (reduce aging over 90/120 days).
• Percentage of claims collected.
• Denial overturn rate.
• Collection call volume and productivity.
• Patient satisfaction in billing interactions.

Job Type: Full-time

Benefits:

• Flexible schedule
• Health insurance
• Paid time off
• Vision insurance