Insurance Collector 1

4 weeks ago

North Little Rock, United States OrthoArkansas Full time
Job DescriptionJob Description

GENERAL DESCRIPTION OF POSITION

The Insurance Collector performs all functions necessary to obtain timely and accurate reimbursement on all medical claims. This includes working front end and soft denials and assisting in writing appeals. Position works directly with providers to maximize their revenues.

ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Responsible for working hold buckets for assigned payers.
  • Responsible for working at least an average of 60 claims per day.
  • Review and investigate unpaid insurance medical claims.
  • Assist in writing appeal letters and communicating with insurance carriers regarding denied claims.
  • Identifies and resolves problems, including but not limited to duplicate or incorrect charges, incorrect coding, erroneous registration, incorrect payer processing and imitates corrections accordingly.
  • Assist in working insurance refunds.
  • Documents all actions and outcomes within billing system.
  • Answer calls, emails, and other forms of communication from OA staff regarding claim or account status.
  • Responsible for working errors from payor websites example: AHIN, Medicaid, CMS etc.
  • Work mail that has been sent from assigned insurance companies.
  • Communicating with Reimbursements Manager prior to w/o claim balance.
  • Research insurance companies’ coverage policies to get claims paid correctly.
  • Maintain physician dashboards.
  • Attend local insurance meetings as needed.
  • Perform any other related duties as required or assigned.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty mentioned satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

EDUCATION AND EXPERIENCE

  • Equivalent to four years high school or GED, with particular emphasis during high school in office skills, shop skills, or others.
  • 0 to 6 months related experience and/or training, or equivalent combination of education and experience.
  • Ability to interact professionally and diplomatically with patients, physicians, hospitals, insurance companies and coworkers.
  • Ability to work in a fast-paced environment accurately & efficiently. Proficient computer skills. Proficient mathematical skills.
  • Thorough knowledge of orthopedic procedures/diagnoses and procedure codes, preferred.
  • Strong organizational skills.
  • Outstanding people skills.
  • Excellent communication skills, both verbal and written.
  • Always maintain HIPPA confidentiality.

REQUIRED CERTIFICATES, LICENSES, REGISTRATIONS

  • None

PREFERRED CERTIFICATES, LICENSES, REGISTRATIONS

  • None

SOFTWARE SKILLS REQUIRED

  • Advanced: Alphanumeric Data Entry
  • Intermediate: 10-Key, Database, Other, Spreadsheet, Word Processing/Typing
  • Basic: Accounting, Contact Management

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