Subject Matter Expert INR Collections

JOB DESCRIPTION:

The INR Collections Subject Matter Expert (SME) serves as the primary escalation point and technical authority for insurance followup and accounts receivable resolution. This role ensurestimelyresolution of unpaid underpaid and denied claims while supporting collectors through expert guidance quality oversight and adherence to payer rules SLAs and compliance standards.

Job Responsibilities:

• Handles complex highbalance and escalated insurance accounts requiring advanced followup and payer negotiation.

• Acts as the subject matter expert on payer rules claim statuses denial codes and resolution strategies.

• Provides mentoring and realtime guidance to INR Collectors on workflows call handling and documentation standards.

• Reviews and resolves payer denials delays and underpayments byidentifyingroot causes and corrective actions.

• Supports appeal development by supplying documentation coordination and payerspecific insight.

• Performs quality audits of INR collection work to ensure accuracy compliance and effectiveness.

• Identifiesdenial trends payer issues and AR aging risks; escalates systemic concerns to leadership.

• Supports development and maintenance of SOPs job aids and training materials.

• Ensures compliance with HIPAA and all confidentiality and regulatory requirements.

• Performs other related duties as assigned.

Minimum Requirements:

• Bachelorsdegree preferred.
• Minimum of 3 years of Revenue Cycle Management experience with strong focus on Insurance collections.
• Advanced knowledge of claim life cycle insurance followup denial management and payer escalation.
• Strong understanding of reimbursement principles
• Proficiencyin RCM systems AR work queues and Microsoft Office.
• Strong attention to detail problemsolving skills and ability to manage highvolume workloads.
• Excellent analytical communication and documentation skills.

Competencies:

• Fostering Teamwork

• Analytical Thinking

• Commitment to Job Deliverables

• Leadership

• Decision making

• Trustworthiness and Ethics

• Attention to Details

• Problem Solving

• Attention to Communication

• Technical Expertise

• Customer Orientation

• Analytical Thinking

• Managing Change

• Adaptability

• Managing Performance

• Stress Management

• Initiative
• Personal Credibility

• Interpersonal Skills
• Flexibility
• Thoroughness
• Self Confidence

Required Skills

COMMUNICATION

• Excellent professional verbal and written communication skills

• Ability to explain complex payer and denial issues clearly

• Strong documentation notetaking and followup skills

• Teamoriented with mentoring capability

TECHNICAL SKILLS

• High attention to detail and analytical accuracy

• Strong Excel Word and Outlookproficiency

• Knowledge of payer portals call documentation and denial workflows

• Strong computer and RCM systemproficiency

PHYSICAL ABILITIES

• Performs repetitive motion activities

• Sits for extended periods of time

• Requires close vision and frequent focus adjustment

• Ability to reach with hands and arms

WORK SCHEDULE

• Works at a standard workstation for extended periods

• Uses standard computer equipment including keyboard and monitor

• No liftingrequiredfor this position

• Must report to work on time and complete assigned shift

• Must be willing to work night shift as required by business needs

The base pay for this position is

In specific locations the pay range may vary from the range posted.

JOB FAMILY:

DIVISION:

LOCATION:

ADDITIONAL LOCATIONS:

WORK SHIFT:

TRAVEL:

MEDICAL SURVEILLANCE:

SIGNIFICANT WORK ACTIVITIES: