AR Insurance Specialist

Description

As a member of the Insurance AR Team, you become laser-focused on closing the loop from unpaid or incorrectly processed claims by following the money and ensuring we collect every dollar that the organization has earned. You understand the nuance and payer-specific tactics needed to turn aged receivables into resolved payments, and you do it with skill, consistency, and tenacity.

Your efforts allow families to continue receiving care for the recommended amount of time by ensuring that correct and timely payer payments are received and applied. You also provide critical insight into payer trends, helping the organization identify errors and strengthen payer accountability, protecting both the families we serve and the financial health of the company.

Key Responsibilities:

• Work daily aging reports with a focus on insurance balances greater than 30 days; prioritize claims based on payer, age, and dollar amount.
• Conduct thorough follow-up with payers via phone, portals, and written correspondence to resolve outstanding claims.
• Investigate claim denials and underpayments by reviewing EOBs/ERAs, payer policies, and contract terms.
• Submit appeals and corrected claims within payer deadlines, ensuring compliance with payer-specific requirements.
• Document all actions taken in the AR system accurately, including notes from payer calls, resubmissions, and escalation steps.
• Escalate recurring payer issues, delays, or system-wide denial patterns to the AR Manager for strategic resolution.
• Collaborate with Contracting, Credentialing, Billing, Authorization, and Eligibility teams to resolve front-end claim issues that impact reimbursement.
• Identify payer trends related to denials, payment delays, or processing errors, and provide feedback to the Quality Assurance Manager for tracking and process improvement.
• Ensure secondary and tertiary claims are billed promptly and payments are applied correctly.
• Maintain compliance with HIPAA and organizational policies when handling PHI during payer communications.
• Consistently meet productivity and quality standards for claims worked, appeals submitted, and resolutions achieved.

Requirements

Desired Qualifications and Experience:

• Minimum 2-3 years of experience in healthcare services, with familiarity working with providers and third-party payors.
• Experience with EHR software and knowledge of ABA therapy highly preferred.
• Strong organizational skills with a structured, detail-oriented approach; thrives in managing complex information.
• Analytical mindset with the ability to make data-driven decisions.
• Demonstrated ability to handle complex challenges with persistence and resilience until resolution.
• Comfortable multitasking and managing multiple projects simultaneously in a fast-paced environment.
• Clear and professional verbal and written communication skills; confident interacting with payors, including cold calling when necessary.
• Proven problem-solving abilities with excellent time management and a track record of meeting deadlines.
• Strong collaboration and teamwork skills while maintaining the ability to work independently.
• Proficiency with Microsoft Office Suite.

Basic & Essential Functions

• Must have manual dexterity to perform specific computer and electronic device functions
• Must have visual acuity to read and comprehend written communication though computer, electronic devices, and paper means.
• Must be able to maintain prolonged periods of working on a computer while sitting at a desk and attending virtual meetings

Job Type: Non-Exempt, Full-Time

Pay is competitive and based on candidate qualifications and experience. Full-time employees will be offered our comprehensive benefits including Paid Time Off, 401k, insurance (health, dental, and vision), and the option of Short and Long-Term disability insurance.

About Bierman Autism Centers:

Our goal is to fuse science and learning to accelerate progress and transform lives. We were established in 2006 with a simple focus on providing excellent therapy for children with autism and building a unique and fun environment for team members and children to thrive. We live by the culture we’ve created and our core values: to create a fun and stimulating learning environment, empower individuals and treat them with kindness, integrity, and respect, never sit still, achieve, and continuously raise the bar, team above the individual, build a sustainable organization that leaves a meaningful impact on lives, and adhere to our core principles without compromise.

Bierman Autism Centers values diversity in the workplace. The company provides equal opportunity for employment and promotion to all qualified employees and applicants on the basis of experience, training, education, and ability to do the available work without regard to race, religion, color, age, sex/gender, sexual orientation, national origin, gender identity, disability, marital status, veteran status, genetic information, ancestry, or any other status protected by law.

Furthermore, Bierman Autism Centers is committed to providing an equal opportunity workplace that is free of discrimination and harassment based on national origin, race, color, religion, gender, ancestry, age, sexual orientation, gender identity, disability, marital status, veteran status, genetic information, or any other status protected by law.

As an equal opportunity employer, Bierman Autism Centers does not discriminate against qualified individuals with disabilities. If you require a reasonable accommodation as a candidate for employment, please inform a member of the Talent Acquisition team.