[Hiring] Insurance Accounts Receivable and Posting Specialist @Sun Life

Role Description

The Insurance A/R & Posting Specialists are responsible for a variety of tasks within the Accounts Receivable (AR) and Revenue Cycle Management (RCM) processes. This includes managing rejections, billing, help desk inquiries, AR follow-up, posting payments, and credit balances. These roles will work within a pod structure, where staff will be assigned specific tasks and rotate through the pods at different times. Cross-training is a key part of this structure, and team members will be responsible for filling in for others as needed, ensuring continuity and consistency of the work.

How you will contribute:

• Claims Follow-Up: Review and follow up on outstanding claims to ensure timely reimbursement. Contact insurance companies, payers, and patients to resolve any discrepancies, denials, or underpayments.
• Denial Management: Investigate claim denials, determine reasons for non-payment, and follow up with the payer to resolve and appeal when necessary.
• Billing: Oversee billing activities, ensuring accurate and timely submission of claims to payers, and address any billing discrepancies.
• Rejections: Identify, investigate, and resolve claim rejections promptly to ensure the timely processing of payments.
• Help Desk: Provide support and respond to internal and external inquiries regarding billing issues, claim statuses, and account discrepancies.
• AR Follow-Up: Manage follow-up on outstanding accounts receivable, ensuring timely resolution of overdue claims and facilitating effective communication with payers.
• Posting: Accurately post payments and adjustments to patient accounts and insurance claims.
• Credit Balances: Identify and resolve credit balances on accounts, ensuring they are handled promptly and according to company policy.
• Cross-Training: Willingness to cross-train in all functions of RCM, including but not limited to billing, refunds, collections, and other processes, to support team flexibility and efficiency.
• Process Improvement: Assist in identifying and implementing process improvements to streamline the AR and billing functions.
• Collaboration: Work closely with other members of the RCM team to ensure timely and effective resolution of claims, share knowledge on payer issues, and improve overall processes.

Qualifications

• High school diploma or equivalent
• Minimum of 3 years of experience in accounts receivable, dental billing, or a related field is required
• Experience in a dental or healthcare environment, ideally within a Dental Service Organization (DSO) or similar multi-location setting.
• Strong knowledge of insurance billing, payment procedures, and AR processes.
• Knowledge of payer guidelines and claims appeals processes.
• Familiarity with dental practice management systems, such as Dentrix or similar PMS platforms.
• Ability to navigate payer portals, insurance company websites, and databases.
• Excellent communication and negotiation skills to resolve issues with insurance payers.
• Strong attention to detail and organizational skills.

Requirements

• Salary range: $43,100 - $58,200
• Commitment to pay transparency and equity.
• Eligibility for a discretionary annual incentive award based on individual and overall business performance.

Benefits

• Comprehensive benefits including generous vacation and sick time.
• Market-leading paid family, parental, and adoption leave.
• Medical coverage.
• Company paid life and AD&D insurance.
• Disability programs and a partially paid sabbatical program.
• 401(k) employer match, stock purchase options, and an employer-funded retirement account.
• Flexible, inclusive, and collaborative work environment that supports career growth.