Insurance Collections Specialist

Gastro Health • Miami, FL

3d • Onsite

About The Position

Gastro Health is seeking a Full-Time Sr. Insurance Collections Specialist to join our team! Gastro Health is a great place to work and advance in your career. You'll find a collaborative team of coworkers and providers, as well as consistent hours. The Senior Insurance Collections Specialist is responsible for leading and supporting the insurance collections team in all aspects of accounts receivable management. This role ensures timely and accurate resolution of insurance claims, denial management, and underpayment trends to meet and exceed departmental goals and KPIs. The Senior Specialist serves as a subject matter expert, managing first-level escalations, streamlining workflows, and mentoring team members to enhance overall effectiveness. In addition to handling complex claims and payer issues, this role participates in training, audits, reporting, and process improvement initiatives. The Senior Insurance Collections Specialist works closely with management to support strategic RCM goals, ensure compliance with policy changes, and drive continuous operational excellence within the AR team.

Requirements

• Experience with a large, growing healthcare organization supporting 100 or more providers and overseeing 10+ team members
• At least 3 years’ experience in insurance collections.
• Experience with large healthcare billing systems (over 100+ providers) a plus
• Knowledge of medical terminology utilized in medical collections and billing (CPT, ICD-10, HCPCS)
• Knowledge with letters of appeal.
• Intermediate experience with Microsoft Excel and Office products is required.
• Experience with HMO, PPO, and Medicare insurances.
• 5+ experience in healthcare industry and 1+ years of supervisory experience/leading a team, in healthcare revenue management cycle roles encompassing all phases of the revenue cycle management
• Must be able to read, interpret, and apply regulations, policies and procedures

Nice To Haves

• Experience with large healthcare billing systems (over 100+ providers) a plus

Responsibilities

• Provides Liaison between the providers of health care services, the patient, or other responsible persons, and revenue sources, to ensure the correctness of charges, a current record of all transactions, and account resolution
• Maintains active communications with insurance carriers and third-party carriers until account is paid.
• Negotiates payment of current and past due accounts by direct telephone and written correspondence.
• Updates patient account information
• Monitors and identifies payer denial trends and problem accounts; communicates patterns to supervisor.
• Runs a monthly aging report based on DOS and current A/R to identify accounts that require follow up.
• Manage all assigned worklist on a daily basis for assigned insurances.
• Utilize collection techniques to resolve accounts according to company’s policies and procedures.
• Report any coding related denial to the Coding Specialist.
• Performs other duties including but limited to faxing information as required, generating retroactive authorization requests, and verifying medical eligibility.
• Conducts necessary research to ensure proper reimbursement of claims.
• Assist with special projects assigned by Billing Manager or Supervisor

Benefits

• Medical
• Dental
• Vision
• Spending Accounts
• Life / AD&D
• Disability
• Accident
• Critical Illness
• Hospital Indemnity
• Legal
• Identity Theft
• Pet
• 401(k) retirement plan with Non-Elective Safe Harbor employer contribution for eligible employees
• Discretionary profit-sharing with employer contributions of 0% - 4% for eligible employees
• Tickets at Work that provides discounts on concerts, travel, movies, and more.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed