Medical Insurance Collections Specialist is responsible for the resolution and collection of problematic and aged insurance claims on behalf of clients. Daily functions include contacting insurance carriers for claim status updates, resubmission of claims, preparing and submitting appeals when necessary. Additional responsibilities include routine follow-up on rejections and denials, and communicating with insurance carriers/third parties.
Ability to meet monthly productivity and performance metrics. Identify claim denial causes. Handle complex calls, identify problems, and escalate issues as needed. Work accounts based on aging report within the claims system. Determine most effective means of collection for each account; apply standard due diligence practices to collect monies owed; compose and send various standard collection letters. Compile information and prepare reports on collection activities, such as outstanding and current account standings. Maintain proper notation in claims system. Strong interpersonal and communication skills to work effectively with a wide range of people, teams, managers, supervisors, and third party payers. Make sound and evaluative judgments; strong organizational, problem solving, and analytical skills. Work as a team member within the department. Document work processes as required. Perform other duties as assigned.
More than 2 years in Medical Billing and Collections experience. Knowledge of Billing Guidelines and ICD-10, CPT, and HCPCS coding. Experience with Medicare and Medicaid billing guidelines and rules, insurance reimbursement methods, and the claims appeal process. Understanding of managed care contracts and capitation payments. Experience with billing and collections of physician commercial insurances. Computer proficiency in Word, Excel, Outlook, general knowledge of internet research and medical billing systems. Knowledge of 3M Encoder. Knowledge of Medical Terminology, Principles of Disease, Anatomy and Physiology. Ability to analyze and interpret reports and related materials. Skill in maintaining special record keeping procedures and recognizing errors in recorded information. Excellent computer skills.
Location
Miami, Florida, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
2 weeks ago