Insurance Collection Specialist 2, Remote, Business Office, FT, 08A-4:30P

Baptist Health South Florida • Coral Gables, FL

2d • $19 - $24 • Remote

About The Position

The Insurance Collection Specialist 2 follows up promptly on assigned accounts using accounts receivable reports and account maintenance activities to collect outstanding balances. The specialist uses available resources to resolve claims, applies payer guidelines and knowledge of ICD-10, CPT-4, and modifiers to manage denials, and understands the levels of the appeals process to optimize recovery. The role includes reviewing medical record documentation and identifying documentation needed to overturn insurance denials. The specialist also identifies resources for drug information and medical necessity terms, understands FDA Label components, and uses compendia resources to support medical necessity appeals. The position assists with training new collection specialists. The estimated pay range is $19.25–$24.45 per hour, depending on experience.

Requirements

• At least 5 years of experience.
• Experience in billing, collections, and appeals.
• Proficiency with MS Word and Excel.
• Excellent written and verbal communication skills.
• Detail-oriented with excellent problem-solving skills.
• Knowledge and understanding of medical terminology, explanations of benefits, and insurance verification applications.
• Knowledge and understanding of ICD-10, CPT-4, and modifiers.
• High school diploma, certificate, GED, training, or equivalent experience.

Nice To Haves

• Completion of an accredited Certified Coding Specialist program is desired.

Responsibilities

• Follow up promptly on assigned accounts using A/R reports and account maintenance activities to collect outstanding balances.
• Use available resources to resolve claims.
• Manage denials using payer guidelines and knowledge of ICD-10, CPT-4, and associated modifiers.
• Understand the levels of the appeals process to optimize recovery efforts.
• Review medical record documentation and identify documentation needed to overturn insurance denials.
• Identify resources for drug information and medical necessity terms and definitions.
• Understand the components of the FDA Label.
• Use compendia resources to support medical necessity appeals.
• Assist in training new collection specialists.

Benefits

• Career growth and development opportunities, with clear pathways and ongoing support.
• Comprehensive health and wellness resources.
• A wellness program that can help employees eliminate their medical plan deductible and reduce out-of-pocket healthcare costs.
• Tuition reimbursement.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED