Insurance Receivable Specialist II

This position is responsible for insurance receivables collections, denials resolution and internal/external customer service. Account portfolio may include accounts less complex in nature. This position is not responsible for providing patient care. Performs insurance follow-up and denial resolution on outstanding claims. Performs contract compliance on outstanding claims, ensuring timely and appropriate reimbursement based on contract terms. Ensures appropriateness of patient responsibility, as assigned by payer/contract/benefit. Resolves clinical and/or authorization denials through CARC analysis and appeals - including clinical documentation review and coordination with UR and/or attending physician.