Title: AR Specialist - COB Denials
JOB PURPOSE:
As a dynamic and experienced AR Specialist – COB Denials, you will be responsible for the follow up of
insurance claims and the resolution of coordination of benefits issues preventing the payment of
outstanding accounts receivable. You must be accountable for daily operational tasks associated with
revenue cycle accounts receivable and utilizing payer websites, written letters and phone calls to patients
and/or payers as well as other resources to ensure claim adjudication.
KEY RESPONSIBILITIES:
Will include but not limited to-
- Work assigned claims with denials related to COB (coordination of benefits)
- Use insurance discovery tools to identify any other payers the member may have that were not
presented at the time of service or became active while admitted
- Contact patient to inquire about other coverages
- Utilize all available resources to identify correct COB including payer portals, insurance discovery
and contacting the member
- Organize calls with the insurance and member to ensure COB is updated
- Request reprocessing of claims when COB is updated
- Mail letters to insurance carriers and/or member requesting additional information to determine
COB
- Work overflow of other claims outside COB denials, as needed
- Other duties as assigned
KNOWLEDGE, SKILLS, ABILITIES:
- Work well under pressure, meet quick deadlines
- Attention to detail
- Familiar w/ Behavioral Health/Mental Health treatment (levels of care)
- Critical Thinking
- Attention to Detail
