Medical Insurance Collections Specialist
4 weeks ago
We are seeking a highly skilled Medical Insurance Collections Specialist to join our team at Prism Health North Texas. This role is responsible for collecting payments from third-party medical, dental, and behavioral health payors, ensuring prompt and accurate payment of claims.
Key Responsibilities- Monitor claims status and follow up on rejected, denied, partially paid, and incorrectly paid claims to insurance carriers in a timely manner.
- Respond to payor correspondence and secure additional documentation required or requested by insurance carriers.
- Identify coding, billing, and/or payment errors and make indicated corrections.
- Communicate patterns of consistent payer delays, systematic denials, and other issues to management.
- Demonstrate a thorough understanding of insurance plan, Medicare, and Medicaid contracted rates, terms, and regulations to identify inaccurate payments and/or adjustments.
- Investigate, analyze, and resolve denials from insurance carriers.
- Understand and analyze EOB/ERA information to verify accuracy of insurance payments and patient balances.
- Post charges, payments, adjustments, etc., as assigned.
- Maintain current knowledge on insurance carrier billing requirements and changes.
- Accurately and timely update insurance, payment, and claim activity information in EHR/billing system.
- Collaborate effectively with patients, providers, and staff to obtain needed information and improve organizational billing and collections performance.
- Detail-oriented, independent critical thinking, and problem-solving skills.
- Demonstrated ability to handle multiple responsibilities and meet tight deadlines in a complex environment.
- Demonstrated knowledge of medical, dental, and/or behavioral health provider reimbursement, medical terminology, ICD-10, CPT, and HCPCS coding.
- Proficiency in MS Word, Excel, and Outlook. Experience with MS Teams preferred.
- Excellent written and oral communication skills.
- Excellent technical and business acumen.
- High school or equivalent education required. Associate's degree, Medical Assistant training, or other relevant certificates, certifications, or post-secondary education preferred.
- Minimum of 3 years' experience in medical collections (medical, dental, and/or behavioral health); billing; coding; and/or denials management required.
- Medical and/or Dental Coding Certification required.
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Medical Insurance Collection Specialist
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4 weeks ago
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Bilingual Collections Specialist
4 weeks ago
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