Behavioral Health Collections Specialist

About the role

We are searching for a Commercial Insurance Collections Specialist to join our team of healthcare professionals. The ideal candidate is highly organized, an incredible multi-tasker, and has the ability to challenge insurance denials and ensure claims are processed for payment. A behavioral health background is a plus but not required.

Responsibilities

• Work directly with the billing team lead on daily tasks, workflow, A/R spreadsheets, refund requests, retractions, payment follow-up, and medical records/appeals requests.
• Complete tasks in a timely and accurate manner, following up with third-party payers for outstanding accounts receivable and insurance reimbursements.
• Research patient benefits and claims for denials or past-due status, documenting all claims for proper follow-up.
• Prioritize workload to reduce outstanding accounts receivable, identifying key projects in collaboration with the billing team.
• Call third-party payers regarding claim rejections, denials, and payment inconsistencies, ensuring follow-up meets department requirements.
• Accurately document all relevant medical claims, spreadsheets, and actions for audit and tracking purposes.
• Take all appropriate steps toward claim resolution for proper reimbursements.
• Organize and maintain schedules for claims follow-up calls with third-party payers.
• Understand, request, and file appeals for proper claim reimbursements.
• Develop expertise and payer-specific knowledge on all aspects of medical claim collections.
• Identify and report collection trends or issues resulting in delayed claim adjudication.
• Interpret explanation of benefits (EOBs) for accuracy and correct payer adjudication.
• Communicate and collaborate with team members regarding payer payments and denial trends.
• Monitor insurance claims and contact insurance companies on behalf of the facility to ensure correct reimbursement for services rendered.
• Respond to insurance companies regarding claims or account status.
• Participate in billing and collection-related meetings to discuss new and ongoing account resolution.
• Assist with special projects related to collections under the direction of the RCM management team.

Skills

• Ability to handle and field all insurance phone calls regarding claims status.
• Knowledge of billing procedures and collection techniques.
• Excellent understanding of accounts receivable (AR) processes.
• Ability to read and understand EOBs.
• Experience using medical billing software (e.g., Collaborate MD).
• Strong task prioritization and multitasking abilities.
• Excellent verbal and written communication skills.
• Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook).
• Ability to answer multi-line telephones.
• Patience, compassion, and a self-directed work ethic with minimal supervision.
• Understanding of HIPAA compliance for all patient information.

Qualifications

• High school diploma or equivalent (preferred).
• 2 years of medical billing experience (preferred).

Benefits

• Health Insurance
• Dental Insurance
• Vision Insurance
• Life Insurance

Schedule

• Full-time, 8-hour shift.
• In-person work location.