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Billing and Collections Specialist

1 month ago

Sarasota, United States Insight Global Full time

Billing and Collections Specialist (Claims and Denials)

Contract-to-hire (intention to convert as permanent after 6 months)

Schedule: M-F, 7am-4pm OR 8am-5pm EST


Insight Global is looking for Billing and Collections Specialist (Claims and Denials) to join our client's healthcare organization in Sarasota, FL. This is a full-time position with flexible starting hours and the ideal candidate will be familiar with medical billing and collection processes for hospital systems.


Must Haves:

  • High School or GED
  • Healthcare insurance collections experience with commercial payors and their portals (Aetna, Cigna, United Healthcare, Medicare/Medicaid, the “blues” (BCBS, Anthem, etc.))
  • Experience with hospital insurance claims and insurance denials (appeal specific)
  • EMR and clearinghouse experience
  • UB-04 claims, 837 denials, and/or CMS1500 claims


Day to Day:

  • 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 daily 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.