Insurance Collection Specialist

Meadows of Wickenburg•Boynton Beach, FL

About The Position

The Insurance Collection Specialist reviews and assesses insurance denials and returned claims, communicates with insurance companies and clients to resolve issues, and follows carrier guidelines and organizational policies and procedures. The role includes claim follow-up, sending medical records, writing appeals, investigating rejected claims, and pursuing payment for the agency. The position provides customer service while protecting confidential information in accordance with HIPAA requirements. It also supports insurance, grant, and client billing functions and records follow-up information in the electronic system. The role requires knowledge of substance abuse billing, coding, collections, third-party payers, reimbursement methods, and medical terminology.

Requirements

High school diploma or GED equivalent with a combination of education and work experience.
Minimum of two (3) years of experience in substance abuse billing, coding, and collections, as written in the posting.
Knowledge of third-party payers, billing requirements, and reimbursement methods.
Knowledge of medical terminology.
Knowledge of claims reimbursement and collection efforts in substance abuse treatment.
Proficiency with relevant computer software and hardware applications, including Word, Excel, PowerPoint, Outlook, electronic medical records, billing systems, and/or scheduling applications.
Strong written and verbal communication skills.
Ability to work independently and as part of a team.
Ability to manage multiple tasks and set priorities.
Ability to handle highly sensitive and confidential information.
Ability to work in a fast-paced, high-energy environment.
Excellent interpersonal and customer-facing skills.
Accuracy and attention to detail.

Nice To Haves

Bachelor's degree.
Experience with KIPU.

Responsibilities

Promote the organization's mission, values, and vision.
Provide excellent customer service to clients and follow confidentiality and privacy protocols in accordance with HIPAA requirements.
Accurately enter data and follow-up notes into the electronic system.
Follow up on processed claims to help ensure payment to the agency.
Work directly with payers to verify client eligibility and payment responsibility, including copays, deductibles, coinsurance, and out-of-pocket maximums.
Assist with insurance denial follow-up, appeals, and reconsiderations.
Assist with insurance, grant, and client billing tasks and functions.
Investigate rejected insurance claims and reprocess denied claims or appeal denied or underpaid claims.
Identify denial patterns and notify senior management of payment-delay issues.
Contact insurance companies regarding outstanding accounts.
Send medical records and write appeals for denied claims.