Insurance Collector

Med Management LLC•Peachtree City, GA

About The Position

This role is responsible for managing and processing insurance claims, ensuring accurate billing, and facilitating timely payments. The Insurance Collector will utilize various tools and systems to review, correct, and release charges, research and resolve billing issues, and communicate with healthcare providers, patients, and insurance representatives. A strong understanding of insurance rules and guidelines, particularly Medicare, as well as medical coding (CPT, ICD-10, modifiers), is essential for success in this position. The role also involves accurate documentation and processing of refund requests.

Requirements

Strong understanding and utilization of Navicure clearinghouse claims tool and Navicure rejection queue.
Comprehension and implementation of claim appeal process.
Knowledge of insurance, especially Medicare, rules and guidelines.
Ability to identify insurance company or proper party (patient) to be billed; identify and bill secondary or tertiary insurances.
Ability to review assigned accounts within the AFF AFC Follow up and Catch All WQs ensuring outstanding, pending, partially paid, and denied claims are paid in a timely manner.
Ability to communicate with health care providers, patients, insurance claim representatives and other parties to clarify billing issues and facilitate timely payment.
Accurate filing of confidential correspondence and documentation.
Ability to review, research, and process refund requests.
Knowledge of CPT, ICD 10, and procedural modifiers.
Ability to consult supervisor, team members, and appropriate resources to solve billing and collection questions and issues.

Nice To Haves

Experience with Epic Care charges.
Experience with AFF AFC Claim Edit Billing Work queue.
Experience with AFF AFC Follow up and Catch All WQs.

Responsibilities

Reviewing, correcting, and releasing Epic Care charges.
Utilizing Navicure clearinghouse claims tool and Navicure rejection queue.
Researching, correcting, and releasing accounts within AFF AFC Claim Edit Billing Work queue.
Implementing the claim appeal process.
Identifying the correct insurance company or party (patient) to be billed, including secondary or tertiary insurances.
Reviewing assigned accounts within the AFF AFC Follow up and Catch All WQs to ensure outstanding, pending, partially paid, and denied claims are paid in a timely manner.
Communicating with healthcare providers, patients, insurance claim representatives, and other parties to clarify billing issues and facilitate timely payment.
Accurately filing confidential correspondence and documentation.
Reviewing, researching, and processing refund requests.
Consulting with supervisor, team members, and appropriate resources to solve billing and collection questions and issues.
Performing any other duties determined appropriate by management.