Accounts Receivable Insurance Specialist – HB, PB, Denials Experience

Carle Health

. Manage accounts receivable in compliance with regulatory, billing, and payer guidelines .

Posted 10/13/2026full-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, including compliance with regulatory and billing guidelines, and effectively resolving claims and denials. Proficient in utilizing clinical applications and payer websites to ensure accurate billing and documentation.

Highest-signal resume keywords

Accounts Receivable ManagementInsurance Claims SubmissionDenials ManagementHIPAA ComplianceProblem-Solving Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Billing GuidelinesClaim EditsCharge Review EditsClearinghouse RejectionsPayer RejectionsMedical Documentation ResearchEligibility VerificationRefund ProcessingAccount AdjustmentsAppeals Preparation

Soft Skills

InitiativeCritical ThinkingConfidentiality ManagementCommunication Skills

Tools & Technologies

Clinical ApplicationsPayer WebsitesBilling System

Industry Keywords

HB ExperiencePB ExperienceDenials ExperiencePayer PortalsThird-Party Payers

About the role

Key responsibilities & impact

Manage accounts receivable in compliance with 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, and third-party payers
Collaborate with Billing, Coding, Cash Posting, and other departments to ensure claims are processed and paid correctly
Monitor, research, and resolve unpaid, rejected, denied, and allowance-discrepancy claims
Document collection activities accurately in the billing system
Research medical documentation, eligibility, billing guidelines, referrals, and authorizations using clinical applications and payer websites
Review undistributed payments and apply them to open balances
Review and resolve incoming correspondence
Identify and request account adjustments
Resolve insurance setup errors to facilitate timely billing
Evaluate credit/balance accounts and process refunds or payer recoupments
Prepare appeals, corrected bills, adjusted accounts receivable entries, and refunds
Answer calls through a department rotation line and direct callers as needed
Perform other duties as assigned

Requirements

What you’ll need

Must have HB, PB, and denials experience
Ability to take initiative, accept direction, and seek guidance appropriately
Ability to manage confidential information sensitively and discreetly 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 resolution actions
Ability to use clinical applications, payer websites, and other systems to retrieve medical documentation, eligibility information, billing guidelines, referrals, and authorizations
Ability to resolve insurance setup errors, charge review edits, claim edits, clearinghouse rejections, and payer rejections
Ability to evaluate credit/balance accounts and process refunds or payer recoupments
Ability to prepare appeals, corrected bills, account adjustments, and refunds according to procedures
Ability to answer department calls and direct callers appropriately

Benefits

Comp & perks

Comprehensive benefits package
Equal Opportunity Employer
Potential for growth and life-long careers