Job description:
Key Responsibilities: Insurance Collections & AR Follow-Up
- Review aging reports to identify unpaid or underpaid claims.
- Contact insurance companies via phone, portal, or written correspondence to resolve outstanding claims.
- Follow up on denied or rejected claims and take corrective action (appeals, resubmissions, corrections).
- Track claim status until full payment is received.
- Escalate complex claims to supervisors when necessary.
Patient Collections
- Reach out to patients regarding outstanding balances in a professional and empathetic manner.
- Set up payment arrangements or explain billing statements.
- Document patient communications and payment commitments.
Denial Management
- Investigate reasons for claim denials or partial payments.
- Correct claim errors and resubmit timely.
- File appeals with insurance carriers as needed.
- Collaborate with the billing/coding team to prevent recurring denials.
Documentation & Reporting
- Maintain accurate and detailed notes of all collection activities.
- Update patient accounts and AR records in the billing system.
- Generate and review AR and collection reports for management.
- Meet monthly collection goals and performance metrics.
Compliance & Customer Service
- Ensure all collection activities comply with HIPAA and healthcare regulations.
- Maintain professionalism and confidentiality in patient/insurance interactions.
- Provide excellent customer service to patients and insurance representatives.
Skills & Qualifications
- Knowledge of medical billing, coding (ICD-10, CPT, HCPCS), and insurance guidelines.
- Experience with claim follow-up, AR management, and denial resolution.
- Strong communication and negotiation skills.
- Ability to analyze EOBs (Explanation of Benefits) and remittance advice.
- Proficiency with billing software and electronic health record (EHR) systems.
- Attention to detail, persistence, and time management skills.
Performance Metrics (KPIs)
- AR days outstanding (reduce aging over 90/120 days).
- Percentage of claims collected.
- Denial overturn rate.
- Collection call volume and productivity.
- Patient satisfaction in billing interactions.
Job Type: Full-time
Benefits:
- Flexible schedule
- Health insurance
- Paid time off
- Vision insurance