ARO Strategy Rep I

Job Title: ARO Strategy Representative I
Department: Accounts Receivable Optimization (ARO)
Reports To: ARO Supervisor / Manager

Impact You Will Make

As an ARO Strategy Representative I, you will play a key role in resolving basic eligibility-related denials by verifying patient coverage and benefits with payers. You will build foundational knowledge of insurance requirements and contribute to the timely and accurate resolution of eligibility issues that directly impact claims reimbursement and revenue cycle performance.

Key Responsibilities

• Navigate the ARO platform and payer portals to manage assigned eligibility denial accounts.
• Verify patient coverage, eligibility dates, and policy details with insurance carriers.
• Identify and document root causes of eligibility denials (e.g., inactive coverage, coordination of benefits, incorrect payer).
• Update and correct insurance information and resubmit claims as appropriate.
• Collaborate with internal team members to ensure timely and accurate resolution of accounts.
• Apply appropriate status codes and follow-up indicators in the system.
• Escalate complex or recurring issues to senior staff or leadership.
• Draft basic payer correspondence or appeals when necessary.
• Adhere to HIPAA regulations and internal compliance policies.

Qualifications

• 2-3 years of experience in healthcare, insurance verification, or related field.
• Basic understanding of health insurance types (Medicare, Medicaid, commercial).
• Strong attention to detail and organizational skills.
• Effective written and verbal communication skills.
• Familiarity with billing forms (UB-04, CMS-1500) and payer correspondence preferred.
• Proficiency in using payer portals, EMR systems, and billing platforms.
• Competency in Microsoft Office tools (Excel, Word).
• Ability to meet productivity and quality benchmarks within the training period.

Preferred Qualifications

• Coursework or certification in medical billing, healthcare administration, or insurance.
• Experience in insurance verification, patient registration, or patient access roles.
• Understanding of Medicaid eligibility processes and tools.