Insurance Collections Specialist

Insurance Collections Specialist

Odyssey Behavioral Healthcare operates a national network of specialized treatment centers for mental health conditions, substance use disorders, and eating disorders. We offer a complete continuum of care from inpatient to intensive outpatient programs along with detox services and transitional housing to support each stage of recovery.

Position Summary

The Insurance Collections Specialist is responsible for identifying, analyzing, and resolving insurance account balances to ensure accurate and timely payment processing. This role supports financial integrity by reducing outstanding receivables and communicating with payers.

Relationships and Contacts

Within the organization: Maintains close and frequent contact with the finance and revenue cycle team members within both the facility-based teams and Odyssey.

Outside the organization: Maintains close and frequent contact with insurance providers and third-party vendors, as necessary.

Position Responsibilities

Essential Responsibilities

1. Processes outstanding insurance claims to point of resolution. 2. Tracks insurance appeals needed throughout the appeals process. 3. Processes coordination of benefit and coverage termed issues. 4. Reports insurance reimbursement trends and barriers to leadership. 5. Manages aging reports and prepares patient balance statements as necessary 6. Reviews Explanation of Benefits (EOBs) and payment postings to validate overpayments and support refund decisions 7. Ensures compliance with all federal, state, and payer-specific refund regulations and timelines 8. Researches and resolves issues related to overpayments, incorrect payments, or duplicate payments 9. Maintains strict confidentiality of all patients financial and healthcare information.

Additional Responsibilities

1. Abides by all company policies and procedures. 2. Performs other duties and projects, as assigned.

Qualifications

Minimum Requirements

Education and Experience

Position requires a high school diploma, bachelor's degree preferred, and two (2) years of directly related experience

Physical Requirements

While performing the duties of this job, the employee will be required to communicate with peers/public, clients and/or vendors

Job performance will require the ability to move throughout the building as well as sit or remain stationary for extended periods of time

While performing the duties of this job, the employee may be required to talk or hear, sit, stand, or walk

Skill Competencies

Demonstrates strong problem solving and analytical skills Demonstrates strong customer service skills Demonstrates proficiency with Microsoft Office (Word and Excel) Demonstrates excellent organizational and time management skills Demonstrates successful collaborative skills working with a variety of groups Demonstrates strong attention to detail Demonstrates functional knowledge of basic behavioral health terminology Demonstrates familiarity with insurance billing policies and practices Demonstrates commitment to the vision and values of Odyssey Behavioral Healthcare