应收保险分析师
A/R Insurance Analyst
卡罗莱纳肿瘤专科医院自1983年以来一直提供富有同情心、以患者为中心的医疗服务,为每位患者量身定制高质量的肿瘤学和血液学服务。患者可以方便地在我们的诊所接受化疗治疗,同时获得专家诊断、治疗以及对多种血液疾病的专业管理。
为什么加入我们?
我们正在寻找有才华、富有同情心且高度积极的个人,他们热衷于带来改变。在卡罗莱纳肿瘤专科医院,您将有机会支持社区肿瘤学的重要工作,同时帮助为所服务的患者和家庭提供卓越的护理和希望。加入一个致力于临床卓越、协作精神并每天改善生活的团队。
职位描述:
职位名称:应收账款保险分析师
组织:卡罗莱纳肿瘤专科医院
地点:远程
部门:账单
汇报对象:账单经理
职位概述
应收账款(AR)保险分析师负责管理和解决未结保险余额,以确保服务获得及时准确的报销。该职位专注于分析支付方活动,识别报销差异,并推动拒绝或未足额支付的索赔解决,以支持卡罗莱纳肿瘤专科医院最佳的收入周期表现。
主要职责
· 审查和分析保险应收账款,识别未支付、未足额支付或被拒的索赔。
· 通过审查支付方政策、编码和文件要求来调查和解决索赔拒付问题。
· 向保险公司提交并跟踪上诉,确保及时跟进和解决。
· 处理特定支付方的工作队列,解决逾期账户并减少应收账款天数。
· 分析拒付和未足额支付的趋势,将系统性问题上报给管理层。
· 与编码、账单和临床团队合作,解决索赔错误并防止未来问题。
· 根据合同协议验证支付方报销的准确性。
· 保持所有账户活动、跟进工作和解决方案的详细准确记录。
· 处理索赔编辑和清分中心拒绝,确保及时重新提交。
· 与保险公司代表沟通,获取索赔状态,澄清报销问题并加快付款。
· 协助识别流程改进机会,以提高收入周期效率。
· 支持重新审核
查看英文原文
Carolina Oncology Specialists has been providing compassionate, patient-centered care since 1983, delivering high-quality oncology and hematology services tailored to each individual's needs. Patients benefit from the convenience of receiving chemotherapy treatments in our clinics, along with expert diagnosis, treatment, and management of a wide range of blood disorders.
Why Join Us?
We are seeking talented, compassionate, and highly motivated individuals who are passionate about making a difference. At Carolina Oncology Specialists, you'll have the opportunity to support the meaningful work of community oncology while helping provide exceptional care and hope to the patients and families we serve. Join a team dedicated to clinical excellence, collaboration, and improving lives every day.
Job Description:
Job Description: Accounts Receivable Insurance Analyst
Organization: Carolina Oncology Specialists
Location: Remote
Department: Billing
Reports To: Billing Manager
Position Summary
The Accounts Receivable (AR) Insurance Analyst is responsible for managing and resolving outstanding insurance balances to ensure timely and accurate reimbursement for services rendered. This role focuses on analyzing payer activity, identifying reimbursement discrepancies, and driving resolution of denied or underpaid claims to support optimal revenue cycle performance at Carolina Oncology Specialists.
Key Responsibilities
· Review and analyze insurance accounts receivable to identify unpaid, underpaid, or denied claims.
· Investigate and resolve claim denials by reviewing payer policies, coding, and documentation requirements.
· Submit and track appeals to insurance companies, ensuring timely follow-up and resolution.
· Work payer-specific work queues to address aging accounts and reduce days in AR.
· Analyze trends in denials and underpayments, escalating systemic issues to leadership.
· Collaborate with coding, billing, and clinical teams to resolve claim errors and prevent future issues.
· Verify payer reimbursement accuracy based on contractual agreements.
· Maintain thorough and accurate documentation of all account activity, follow-up efforts, and resolutions.
· Work claim edits and clearinghouse rejections to ensure timely resubmission
· Communicate with insurance representatives to obtain claim status, clarify reimbursement issues, and expedite payments.
· Assist in identifying process improvement opportunities to enhance revenue cycle efficiency.
· Support reporting efforts related to AR performance, denial trends, and payer behavior.
· Ensure compliance with all regulatory and payer guidelines.
Required Qualifications
· High school diploma or equivalent required; Associate’s or Bachelor’s degree in Healthcare Administration, Finance, or related field preferred.
· Minimum of 2–4 years of experience in medical billing, insurance follow-up, or accounts receivable within a healthcare setting.
· Strong knowledge of insurance claim processing, EOBs/ERAs, denial management, and payer requirements.
· Familiarity with CPT, ICD-10, and HCPCS coding concepts.
· Experience working with practice management systems and Microsoft Excel.
· Strong analytical, problem-solving, and critical thinking skills.
· Excellent attention to detail and organizational abilities.
· Effective communication skills, both written and verbal.
Preferred Qualifications
· Experience in oncology or other specialty practice environments.
· Knowledge of payer contracts and reimbursement methodologies.
· Experience with appeals and escalation processes for complex claims.
· Understanding of regulatory requirements affecting healthcare revenue cycle operations.
Key Competencies
· Analytical Thinking
· Problem Resolution
· Attention to Detail
· Accountability & Follow-Through
· Communication & Collaboration
· Time Management
Working Conditions
· Primarily office-based with prolonged computer use.
· May require extended hours to meet deadlines or reduce AR backlog
Originally posted on Himalayas