Carle Health
Carle Health
Carle Health is an integrated healthcare organization serving community health needs through general medical care and specialized services, including oncology, cardiovascular care, pediatrics, and women's health. Its work also extends to medical education and research through the Carle Illinois College of Medicine, alongside community health initiatives focused on improving overall well-being. The organization’s broad healthcare and education operations support opportunities across clinical, administrative, research, and related professional teams.

Remote Accounts Receivable Specialist – VA/Tricare HB/PB Billing

Carle Health is seeking a remote Accounts Receivable Specialist in Illinois to manage VA and Tricare hospital and professional billing claims. The role focuses on payer follow-up, denials, rejections, appeals, and outstanding receivables.

Description

  • Manage accounts receivable in line with compliance, regulatory, billing, and payer requirements
  • Collect outstanding balances through payer portals and telephone contacts
  • Verify coverage and resolve charge-review edits, claim edits, clearinghouse rejections, and payer rejections
  • Submit accurate electronic and paper insurance claims
  • Process non-complex reconsiderations and appeals
  • Research and resolve unpaid, rejected, denied, and allowance-discrepancy claims
  • Conduct account follow-up and collection activities
  • Record collection work accurately in the billing system
  • Resolve denied and rejected invoices and prepare payer corrections and appeals
  • Use clinical applications, payer websites, and other systems to obtain documentation, eligibility details, billing guidelines, referrals, and authorizations
  • Apply undistributed payments to outstanding balances
  • Review and resolve billing-related correspondence
  • Request account adjustments and communicate with patients, insurers, public agencies, internal departments, and third-party payers
  • Correct insurance setup issues and billing edits
  • Review credit and balance accounts, issue refunds, and initiate payer recoupments
  • Prepare appeals, adjusted and corrected bills, accounts receivable adjustments, and refunds
  • Answer departmental calls on a rotating line and route callers appropriately
  • Work with Billing, Coding, Cash Posting, and other departments
  • Complete additional duties as assigned

Requirements

  • High school diploma or GED
  • Experience handling VA and Tricare hospital and professional billing
  • Strong written and verbal communication skills
  • Demonstrated commitment to maintaining confidentiality
  • Capacity to manage a high volume of work
  • Ability to handle multiple tasks effectively
  • Ability to manage confidential information in accordance with HIPAA requirements
  • Strong problem-solving and critical-thinking abilities
  • Ability to take initiative, follow direction, and seek guidance when appropriate

Benefits

  • Comprehensive benefits package
  • Equal Opportunity Employer
  • Participates in E-Verify

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