Medical Insurance Collector

Summary

The Collector is responsible for the accounts receivable including the collection, coordination of billing processes and communicating trends and patterns to the claims and finance team. Properly apply contractual obligations and adjustments when performing billing functions. A key function of this role is coordinating tasks to ensure all deadlines, both external and internal, are met.

Duties & Responsibilities

• Correctly and efficiently reviews demographic and patient insurance data in our proprietary billing system as it relates to covered services and areas.
• Accurately assess claims and identify any problematic issues associated with adjudication that may impact upstream billing to payers.
• Effectively communicate with insurance companies to ascertain claim status and accurate claim dispositions.
• Review 277/277CA responses and complete rejection process.
• Review 835s and rebill claims, as necessary.
• Review denials to determine appropriate action based on carrier requirements.
• Provide follow up with payers or internal claims processing team on denied or unpaid claims as applicable to the root cause of the denial; this could be an insurance plan error or internal processing such as in the case of coordination of benefits or billing configuration.
• Serve as the point of contact for all inquiries from insurance companies, while providing superior customer service.
• Continued professional development desired and encouraged.
• Maintain strictest confidentiality; adhere to all HIPAA (Health Insurance Portability and Accountability) and other industry rules and regulations.

Requirements & Qualifications

• A minimum of 3 years’ experience in end-to-end revenue cycle management
• High school diploma required; Associate’s/bachelor’s degree is a plus.
• Knowledge of billing procedures and collection techniques
• Professional personal presentation
• Experience working independently, as well as member of various teams and/or workgroups.
• Strong computer skills and knowledge of MS Office products, specifically Excel.
• Ability to quickly navigate between different system platforms.
• Strong written and verbal communication skills.
• Strong organizational skills, problem-solving, and analytical skills.
• Acute attention to detail.
• Bilingual (English/Spanish)

Job Type: Full-time

Pay: $18.00 - $24.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Referral program
• Vision insurance
• Work from home

Weekly day range:

• Monday to Friday

Work setting:

• Remote

Application Question(s):

• Are you familiar with various types of files like 237, 834, 835, 837, 999 & etc.?
• Do you have recent TPA experience, preferably working with payers, collectors, and or claims? If so, what is the name of the TPA you worked for?
• What is your process to appeal a claim, denial and or rejection?
• Which portals are you familiar with?
• What insurances or specialties have you worked with?
• Are you familiar with diagnosis codes, procedures, and place of service?

Experience:

• end to end revenue cycle management: 3 years (Required)

Ability to Relocate:

• Miami, FL 33126: Relocate before starting work (Required)

Work Location: In person