Insurance Accounts Receivable Representative

Insurance Accounts Receivable Representative

We are looking for a full-time Insurance Accounts Receivable Representative to join our top notch team of professionals!

Hours will be Monday-Friday 8 am - 5 pm, with rotating Saturdays

Overview

We are seeking an experienced Insurance AR Representative with a solid understanding of payer guidelines, denial management, and appeals processes. The ideal candidate will be proficient in working claims in Athenahealth (Athena), comfortable interpreting Explanation of Benefits (EOBs), and capable of resolving insurance claim denials efficiently and accurately.

Job Duties

• Follow up on outstanding insurance claims to ensure timely payment.
• Review and analyze EOBs to identify underpayments, denials, or discrepancies.
• Prepare and submit effective appeals for denied or incorrectly paid claims.
• Maintain current knowledge of payer policies, guidelines, and billing requirements.
• Collaborate with internal teams to resolve coding or billing errors.
• Document all follow-up activity and payer communications accurately in the system.
• Monitor aging reports and prioritize high-dollar and time-sensitive claims.

Requirements

Job Qualifications:

• 2+ years of experience in insurance AR, billing, or claims follow-up in a medical practice or healthcare setting.
• Proven experience in appealing denied claims is required.
• Strong understanding of payer-specific rules, policies, and reimbursement guidelines.
• Athenahealth system experience strongly preferred.
• Ability to read and interpret EOBs and remittance advice.
• Excellent written and verbal communication skills.
• Strong attention to detail and organizational skills.
• Ability to work independently and manage a high-volume workload.

Sterling Ridge Orthopaedics & Sports Medicine