US Healthcare AR Claims & Collections Specialist

Role and Responsibilities

• Read contracts for payment disputes and review associated documentation.
• Work on the provider side to verify claim status and collect unpaid claims from insurance.
• Process claims payments, manage denials, and track claim statuses.
• Manage collections for healthcare unpaid claims and monitor outstanding balances.
• Interact with customers to ensure invoice accuracy and resolve claims discrepancies.
• Provide input on policies, systems, methods, and procedures for premium collection management.
• Educate customers on online applications for claims and payments.
• Prepare invoices and reconcile billing with accounts receivables.
• Conduct quality assurance and audits of collection activities.
• Handle documents, emails, and calls related to account processes.
• Perform accounts receivable collections, follow-up, denial management, claims payment processing, tracking, and appeals for hospital processes.
• Ensure confidence in the exceptional care provided to members, families, facilities, and health professionals.