Accounts Receivable Specialist – Insurance, HB, Denials, Appeals

Carle Health

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

Posted 9/22/2026full-timeRemote • Illinois • United StatesMid-LevelSenior💰 $17 - $28 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing accounts receivable, including billing, claims processing, and compliance with regulatory requirements. Proficient in resolving claim denials and rejections while maintaining confidentiality in a HIPAA-compliant manner.

Highest-signal resume keywords

Health Insurance Claims ManagementAccounts Receivable ProcessesClaim Denial ResolutionBilling Guidelines ResearchCritical Thinking Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Accounts Receivable ManagementInsurance Claims SubmissionClaim Edits ResolutionPayer Portal ResearchBilling System Documentation

Soft Skills

Problem-Solving SkillsInitiativeDiscretion in Handling Confidential Information

Tools & Technologies

Clinical ApplicationsBilling Systems

Industry Keywords

HIPAA CompliancePayer RequirementsReconsiderations and AppealsCharge Review EditsClearinghouse Rejections

About the role

Key responsibilities & impact

Manage accounts receivable in accordance with compliance, regulatory, billing, and payer requirements
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 unpaid, rejected, denied, and allowance-discrepancy claims
Complete basic reconsiderations and appeals
Answer, document, and resolve inquiries from patients, insurers, public agencies, internal departments, and third-party payers
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
Request adjustments, prepare corrected bills, adjust accounts receivable entries, and process refunds as appropriate
Collaborate with Billing, Coding, Cash Posting, and other departments to ensure claims are correctly processed and paid
Answer departmental calls on a rotating basis and direct callers to the appropriate representative
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 sensitively and discreetly in a HIPAA-compliant way
Strong problem-solving and critical thinking skills
Experience with health insurance claims, denials, appeals, billing, and accounts receivable processes
Ability to submit electronic and paper claims, reconsiderations, and appeals
Ability to research payer portals, clinical applications, eligibility information, billing guidelines, referrals, and authorizations
Ability to analyze accounts and determine appropriate resolution actions
Ability to document collection activities accurately in billing systems
Ability to resolve denied/rejected invoices, allowance discrepancies, claim edits, charge review edits, and payer rejections
Ability to evaluate credit/balance accounts and process refunds or payer recoupments
Ability to answer departmental calls and direct inquiries appropriately

Benefits

Comp & perks

Comprehensive benefits package
Equal opportunity employment
Potential for growth and life-long careers