Medical Insurance Collections Specialist
1 week ago
We are seeking a highly organized and detail-oriented Medical Insurance Collections Associate to join our team at Atlantic Vision Partners. As a Medical Insurance Collections Associate, you will be responsible for filing insurance claims, managing patient accounts, and answering account status inquiries on optometry and ophthalmology patients.
Key Responsibilities- Enter information necessary for insurance claims, including patient insurance ID, diagnosis and treatment codes, and provider information.
- Submit insurance claims to clearinghouses or individual insurance companies electronically or via paper CMS-1500 form.
- Answer patient questions on patient responsible balances, copays, deductibles, write-offs, and resolve patient complaints or explain why certain services are not covered.
- Follow up with insurance companies on unpaid or rejected claims, resolve issues, and re-submit claims.
- Prepare appeal letters to insurance carriers when not in agreement with claim denial, collect necessary information to accompany appeal.
- Follow up on past due patient balances and provide necessary information to collection agencies for delinquent accounts.
- May perform "soft" collections for patient past due accounts, including contacting and notifying patients via phone or mail.
- Prepare and submit secondary claims upon processing by primary insurer.
- Post insurance and patient payments using medical claim billing software as needed.
- Understand managed care authorizations and limits to coverage, such as number of visits.
- Verify patient benefits eligibility and coverage.
- High School Diploma or equivalent required.
- Computer skills, including experience in a Windows Operating System, e-mail, and data entry experience.
- Prior experience with medical billing software is preferred but not required.
- Three to five years in insurance billing required.
- Excellent judgment, dependability, and conscientiousness.
- Demonstrated high ethical standards and integrity.
- Demonstrated attention to detail.
- Demonstrated accuracy and thoroughness; monitors own work to ensure quality.
- Customer and patient service orientation: prompt response to patient needs and ability to manage difficult or emotional customer situations with tact, empathy, and diplomacy.
- Ability to work cooperatively in group situations; offers assistance and support to coworkers, actively resolves conflicts, inspires trust of others, and treats patients and coworkers with respect.
- Patient-centered care focused, and a team player.
- Handles multiple tasks effectively and efficiently and exhibits commitment to effective problem-solving techniques when issues arise.
- Continuously acts to maintain a safe, clean, healthy, and fun work environment consistent with AVP's Mission and Vision.
- Arrives on time, ready to work, and demonstrates minimal absenteeism.
- Demonstrates effective problem-solving skills.
- Knowledgeable of Medicare and Medicaid billing and reimbursement concepts and principles.
- Willingness to submit to a background check.
- We've got you covered in more ways than one. As a full-time employee, you receive medical, dental, vision, a 401k plan, long-term disability, and life insurance. Pay is determined based on qualifications and experience.
- Paid vacation and holidays (+ two floating holidays).
- Tuition reimbursement opportunities.
- Referral bonus opportunities.
- Discount on designer eyewear.
- Paid certified accreditation program.
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