Accounts Receivable Insurance Specialist, Denials

Carle Health

. Manage accounts receivable according to compliance, regulatory, billing, and payer guidelines .

Posted 11/4/2026full-timeRemote • Illinois • United StatesMid-LevelSenior💰 $17 - $28 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing accounts receivable, ensuring compliance with billing and payer guidelines, and resolving claims issues effectively. Proficient in utilizing clinical applications and payer websites to facilitate accurate billing and claims processing.

Highest-signal resume keywords

Accounts Receivable ManagementInsurance Claims SubmissionProblem-Solving SkillsHIPAA ComplianceClaim Resolution

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Billing GuidelinesInsurance ClaimsPayer CorrectionsCharge Review EditsClearinghouse RejectionsClaim EditsAccount AdjustmentsPayer RecoupmentsMedical Documentation RetrievalEligibility Information

Soft Skills

InitiativeCritical ThinkingSensitivityDiscretion

Tools & Technologies

Clinical ApplicationsPayer WebsitesBilling System

Industry Keywords

ComplianceRegulatory GuidelinesPayer GuidelinesAppealsUnpaid ClaimsDenied ClaimsAllowance Discrepancies

About the role

Key responsibilities & impact

Manage accounts receivable according to compliance, regulatory, billing, and payer guidelines
Collect outstanding receivables through payer portals and phone lines
Validate coverage and accurately bill insurance claims
Resolve charge review edits, claim edits, clearinghouse rejections, and payer rejections
Follow up on outstanding receivables and complete basic appeals
Answer, document, and complete inquiries from insurance companies, internal departments, patients, public agencies, and third-party payers
Monitor, research, and resolve unpaid, rejected, denied, and allowance discrepancy claims
Document collection activities in the billing system
Prepare payer corrections, corrected bills, appeals, refunds, account adjustments, and payer recoupments
Review undistributed payments and apply them to open balances
Review and resolve incoming correspondence
Collaborate with Billing, Coding, Cash Posting, and other departments to ensure claims are processed and paid correctly
Answer department calls through a rotation line and direct callers as appropriate
Perform other duties as assigned

Requirements

What you’ll need

Ability to take initiative, accept direction, and seek guidance appropriately
Ability to manage confidential information with sensitivity and discretion in a HIPAA-compliant way
Strong problem-solving and critical thinking skills
Ability to submit accurate electronic and paper insurance claims
Ability to submit non-complex reconsiderations and appeals via paper, fax, or web portal
Ability to monitor, research, and resolve unpaid, rejected, denied, and allowance discrepancy claims
Ability to analyze accounts and determine appropriate account-resolution actions
Ability to use clinical applications, payer websites, and other systems to retrieve medical documentation, eligibility information, billing guidelines, referrals, and procedure-code authorizations
Ability to resolve insurance setup errors, charge review edits, claim edits, clearinghouse rejections, and payer rejections
Ability to evaluate credit/balance accounts and initiate refunds or payer recoupments
Certifications, education, and work experience are not specified

Benefits

Comp & perks

Comprehensive benefits package
Flexible schedule once trained