Insurance Collections Analyst
Role Overview
The insurance collections role covers insurance verification and claims, Workers’ Compensation claims, collections, payment posting, appeals, accounts receivable support, and phone inquiries.
The role provides efficient service to physicians and courteous, compassionate service to patients while following clinic policies and procedures.
Key Skills for This Role
Full Job Posting
Position overview
The insurance collections role covers insurance verification and claims, Workers’ Compensation claims, collections, payment posting, appeals, accounts receivable support, and phone inquiries.
The role provides efficient service to physicians and courteous, compassionate service to patients while following clinic policies and procedures.
Essential job functions
- Verify and file insurance and Workers’ Compensation claims and follow up on pending claims.
- Assist with payment agreements and process patient payments by phone or mail; perform daily billing and work front-end rejections.
- Collect outstanding patient balances, including nonsufficient-fund checks, and post payments with corresponding explanations of benefits.
- Answer calls about patient balances and insurance questions; sort, answer, and file correspondence; correct and adjust patient accounts.
- Complete the monthly NextGen work log by its due date and perform typing, faxing, fax distribution, shredding, and photocopying.
- Liaise between physician offices and insurance companies, supplying additional information when requested.
- Keep the supervisor informed, provide feedback, document and report occurrences, and meet deadlines while using resources appropriately.
- Follow regulatory and company requirements, maintain confidentiality of patient medical and administrative information, and support company policies and management decisions.
- Demonstrate dependable attendance, concentration, constructive conduct, sound judgment, and effective working relationships with staff, patients, and the public.
Position requirements
- High school diploma or GED equivalent is required.
- Two years of insurance, billing, and collection experience is required; physician-office experience is preferred.
- Strong knowledge of ICD-10 and CPT coding and computer experience are required.
- Excellent oral and written communication, interpersonal, problem-solving, and organizational skills are required.
- Occasional overtime, evening, and weekend work is required.
- A valid driver’s license, dependable automobile, and current auto insurance are required for occasional business travel and satellite-location work.
Physical requirements
- The role involves prolonged sitting and some bending, stooping, stretching, or other moderate physical exertion, and requires stamina for sustained activity.
- Candidates must be able to read information in varied formats, hear for work purposes, and use a keyboard, photocopier, telephone, calculator, and other office equipment with eye-hand coordination and manual dexterity.
- The role requires lifting up to 25 pounds.
Work environment
- Work is generally performed under normal office conditions with normal visual strain.
- The work may involve stress from public interaction, multiple demands, and extraneous noise, as well as possible exposure to contagious diseases.
Tools and compliance
- The description identifies NextGen for monthly work logs and requires knowledge of ICD-10 and CPT coding, computer experience, and compliance with OSHA, CLIA, and HIPAA requirements.
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