Insurance Collections Specialist

5 days ago


Miami FL USA, United States Femwell Group Health Full time
About Femwell Group Health

Femwell Group Health is a leading management services organization that supports hundreds of physicians in Florida, providing operational health services to help them focus on patient care.

We are seeking a highly organized and detail-oriented Insurance Collections Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for providing insurance collections support to our billing and collections clients.

Essential Job Functions
  • Liaise between Billing and Collections, Clients, and IKS to ensure seamless communication and efficient processing of claims.
  • Oversee revenue cycle and accounts receivable for multiple provider offices, ensuring timely and accurate processing of claims.
  • Review and complete tasks sent by IKS through the Optimix platform, ensuring accuracy and compliance with regulatory requirements.
  • Approve or deny appeals sent through the Optimix platform, ensuring that claims are processed in accordance with payer guidelines.
  • Generate appeals and reconsideration letters as needed to resolve denials and underpayments.
  • Perform follow-up activities on accounts to ensure prompt payment and resolve any issues that may arise.
  • Monitor insurance claims denials and identify trends to improve processing efficiency.
  • Review Time Sensitive Documents and take appropriate action to ensure timely processing of claims.
  • Provide excellent customer service to our billing and collections clients via email and phone calls.
  • Maintain open lines of communication with the team and manager to ensure seamless collaboration and problem-solving.
  • Maintain compliance with HIPAA guidelines and ensure that all claims are processed in accordance with regulatory requirements.
Requirements
  • High school diploma or equivalent required.
  • Experience working with Microsoft Office, specifically Excel, Outlook, and Word.
  • Highly organized and detail-oriented with excellent communication and customer service skills.
  • Ability to comprehend various insurance documentation, analyze and reconcile accounts, and follow detailed procedures in an efficient manner.
  • Knowledge of commercial insurance and government payor guidelines.
  • Understanding of insurance benefits and reimbursements.


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