Senior Billing and Collections Specialist

2 weeks ago


Los Angeles, California, United States Insight Global Full time

Position Overview:
Insight Global is seeking a fully remote Senior Billing and Collections Specialist to join our dynamic team. This role is open to candidates residing in select states.

Key Responsibilities:
The selected candidate will be instrumental in managing the reimbursement process for claims submitted to various insurance providers. A strong understanding of managed care agreements and current regulatory standards is essential to ensure timely and precise reimbursements.

  • Billing Proficiency: Exhibit comprehensive knowledge of billing protocols for government, commercial, HMO, PPO, and other insurance types across multiple jurisdictions.
  • Hospital Billing Experience: Skilled in utilizing the EPIC system for hospital billing operations.
  • Reimbursement Acumen: Familiarity with reimbursement methodologies for all payer types.
  • Payer Collaboration: Engage with payers to guarantee accurate reimbursements and to identify and correct any discrepancies in fee schedules.
  • Insurance Eligibility Insight: Understanding of insurance eligibility requirements and coverage benefits.
  • Claims Oversight: Update insurance coverage information and resubmit claims as necessary.
  • Issue Resolution: Analyze insurance plan guidelines against patient accounts to pinpoint and resolve claim processing delays.
  • Account Management: Effectively manage assigned accounts, including obtaining claim statuses, addressing insurance inquiries, and conducting necessary follow-ups.
  • Quality Control: Ensure that all resolutions adhere to departmental standards.
  • Evaluation of Late Charges: Assess late charges and adjustments in relation to billing.

Research and Appeals:
Conduct thorough research on accounts through payer websites, verify claims, and review detailed bills, medical records, and appeal documentation.

  • Underpayment Handling: Process adjustments to finalize accounts post-payment and draft disputes and appeals for underpayment scenarios.

Company Commitment:
At Insight Global, we are dedicated to fostering diverse and inclusive workplaces where individuals can express their authentic selves. We are an equal opportunity employer, and we value every candidate's unique background.

Qualifications:
To be considered for this role, candidates should possess:

  • Experience in Anesthesia collections.
  • A minimum of 5 years in professional billing and collections, specifically within a hospital setting.
  • CPC Certification.
  • Experience across multiple specialties, including surgical procedures.
  • Strong understanding of payer contracts, with the ability to interpret and analyze each contract.
  • Experience managing high-volume commercial and government collections, processing over 40 claims daily.
  • Proficiency in Excel and EPIC.
  • Technical proficiency with a reliable home internet connection to facilitate remote work.


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