Insurance Collection Specialist

Benefits

• 401(k)
• Dental insurance
• Health insurance
• Opportunity for advancement
• Paid time off
• Vision insurance
• 401(k) matching
• Flexible schedule

Qualifications

• Proven experience in medical insurance collection department.
• Strong knowledge of medical appeal guidelines and insurance verification processes.
• Proficiency in managing appeals and conducting insurance verification.
• Strong communication skills (written and verbal).
• Proficient in Microsoft Excel.
• Knowledge of medical billing guidelines across multiple specialties, including but not limited to OB/GYN, Cardiology, Gastroenterology, and Primary Care.

Responsibilities

• Analyze reimbursement procedures and account activity to ensure maximum reimbursement.
• Review and evaluate denials to determine and implement required actions to overturn denials.
• Identify denial trends related to assigned clients in efforts to implement corrective actions.
• Achieve unit daily account average target and work diligently to maintain assigned client's AR below 18%.
• Utilize insurance portals to appeal denied claims.
• Focus on payer profiles, contract adherence, and denied claim resolution.
• Identify problem trends such as incorrect coding, carrier nonpayment patterns, and physician coding inconsistencies.
• Maintain and promote a positive, and professional work environment while maintaining strict confidentiality.
• Provide consistent support to clients, management, and team members.

Job Type

Full-time

Schedule

• 8-hour shift
• Monday to Friday
• Flexible work from home options available.