Billing/ Insurance Collections Analyst
About The Position
Claimpay, Inc. is seeking a Billing/Insurance Analyst/Collector specializing in workers’ compensation pharmacy claims for patients who receive medication dispensed in an office. The role follows up on outstanding claims, gathers information requested by payors, and performs basic billing work, including correcting, resubmitting, and appealing claims. The analyst meets department productivity and claim-resolution targets and evaluates unresolved workers’ compensation claims to help resolve them. This is an in-office role, Monday through Friday, and is not remote. The work includes communicating with carriers, third-party administrators (TPAs), and adjusters; reviewing explanations of benefits (EOBs) and denial codes; collecting underpaid amounts; preparing appeal letters that cite state fee schedules; and documenting communications.
Requirements
- High school diploma or equivalent.
- Two years of office experience in medical billing or collections is preferred.
- Knowledge of EOBs, copays, insurance, deductibles, and denial codes.
- Knowledge of medical billing and collection practices.
- Attention to detail and ability to prioritize independently.
- Ability to multitask in a busy office environment.
- Proficient customer service skills.
- Intermediate knowledge of Microsoft Office.
- Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
- Ability to write routine reports and correspondence.
- Ability to speak effectively before groups of customers or employees.
- Ability to perform arithmetic using whole numbers, common fractions, and decimals.
- Ability to apply common-sense understanding to carry out written, oral, or diagrammed instructions.
- Ability to deal with problems involving several concrete variables.
- Interpersonal, verbal and written communication, and listening skills.
- Problem analysis and problem-solving skills.
- Adaptability, initiative, and stress tolerance.
- Intensity.
Nice To Haves
- Two years of office experience in medical billing or collections.
Responsibilities
- Follow up with carriers, TPAs, and adjusters regarding outstanding claims and payments.
- Gather additional information requested by payors and assist with payor follow-up requests.
- Review EOBs and interpret denial codes.
- Perform basic billing functions, including correcting, resubmitting, and appealing claims.
- Collect payments and address claims reduced to contract rates.
- Prepare appeal letters citing applicable state fee schedules.
- Evaluate unresolved workers’ compensation claims to facilitate resolution.
- Meet department productivity and claim-resolution targets.
- Document conversations and other claim-related communications.
- Perform other duties as assigned.
Benefits
- Coffee and camaraderie with coworkers.
- Job security, as described in the posting.
- Satisfaction of pursuing payments owed by carriers.
- Exposure to state fee schedules and workers’ compensation claims.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
