Insurance Collections and AR Agent

Job description:

Key Responsibilities: Insurance Collections & AR Follow-Up

• Review aging reports to identify unpaid or underpaid claims.


• Contact insurance companies via phone, portal, or written correspondence to resolve outstanding claims.


• Follow up on denied or rejected claims and take corrective action (appeals, resubmissions, corrections).


• Track claim status until full payment is received.


• Escalate complex claims to supervisors when necessary.

Patient Collections

• Reach out to patients regarding outstanding balances in a professional and empathetic manner.


• Set up payment arrangements or explain billing statements.


• Document patient communications and payment commitments.

Denial Management

• Investigate reasons for claim denials or partial payments.


• Correct claim errors and resubmit timely.


• File appeals with insurance carriers as needed.


• Collaborate with the billing/coding team to prevent recurring denials.

Documentation & Reporting

• Maintain accurate and detailed notes of all collection activities.


• Update patient accounts and AR records in the billing system.


• Generate and review AR and collection reports for management.


• Meet monthly collection goals and performance metrics.

Compliance & Customer Service

• Ensure all collection activities comply with HIPAA and healthcare regulations.


• Maintain professionalism and confidentiality in patient/insurance interactions.


• Provide excellent customer service to patients and insurance representatives.

Skills & Qualifications

• Knowledge of medical billing, coding (ICD-10, CPT, HCPCS), and insurance guidelines.


• Experience with claim follow-up, AR management, and denial resolution.


• Strong communication and negotiation skills.


• Ability to analyze EOBs (Explanation of Benefits) and remittance advice.


• Proficiency with billing software and electronic health record (EHR) systems.


• Attention to detail, persistence, and time management skills.

Performance Metrics (KPIs)

• AR days outstanding (reduce aging over 90/120 days).


• Percentage of claims collected.


• Denial overturn rate.


• Collection call volume and productivity.


• Patient satisfaction in billing interactions.

Job Type: Full-time

Benefits:

• Flexible schedule


• Health insurance


• Paid time off


• Vision insurance