Healthcare Insurance Recovery Specialist

2 weeks ago


Tomball, Texas, United States Sentido Health Full time
Job Overview

We are seeking a skilled Insurance Collections Specialist to manage the recovery of payments on patient accounts within the healthcare sector. This role is pivotal in ensuring optimal reimbursement from insurance providers.

Key Responsibilities
  • Claims Management: Proactively follow up on outstanding claims and unpaid accounts, identifying and resolving billing and collection issues.
  • Denial Resolution: Conduct thorough research to resolve claim denials and discrepancies, including contacting insurance companies and appealing denials as necessary.
  • Payment Analysis: Interpret Explanation of Benefits (EOBs) and remittance advice to ensure accurate payments are received.
  • Account Oversight: Monitor and maintain assigned accounts, including adjustments, reconciliations, and processing refunds.
  • Compliance: Ensure adherence to corporate policies, third-party payer requirements, and governmental regulations.
  • Communication: Effectively communicate with team members and management regarding collections and payment issues.
Performance Metrics

Success in this role will be measured by:

  • Timely submission of appeals and corrected claims.
  • Efficient handling of incoming mail and payment postings.
  • Regular review of aging reports to ensure all claims are filed appropriately.
Qualifications

Preferred experience includes:

  • Familiarity with Brightree and DME Collections.
Work Environment

This position may be performed in-office or remotely, with a full-time schedule of Monday through Friday.

Skills Required
  • Strong communication skills, both verbal and written.
  • Detail-oriented with excellent time management abilities.
  • Ability to multitask while providing exceptional customer service.

Please note that this job description is not exhaustive and may be subject to change as needed.



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