Insurance Collector

Insurance Claims Specialist

Submit insurance claims manually, via fax, and insurance portals when required. Responsible for contacting insurance carriers and following up on outstanding claims. Identifying, completing, and resolving insurance denials in a timely manner to expedite claims processing and payment. Knowledge of insurance EOB's layout/language and requirements for various insurance carriers. Appealing insurance claims when required. Ensuring excellent customer service is provided when following up on outstanding claims. Responsible for daily/weekly & monthly reporting of following reports: Dept Overview, productivity reports, Posting Review Schedule, Insurance Negotiations/ Settlements. Identify insurance trends that negatively impact cash collections, utilize training tools provided to resolve issues and/or escalate to Dept Manager/ Director. Responsible for completing Dept projects as assigned. Provide general administrative and clerical support including but not limited to, receiving, and sorting daily mail, maintaining medical records, faxing, copying, and scanning. Work closely with Dept Managers/Supervisors to create improvement & implement processes to ensure Dept goals and objectives are met in a consistent.

High School Diploma, associate degree preferred. Ambulance/Medical billing certification or diploma preferred. Maintain working knowledge of ICD-10, CPT and HCPCS coding, NPI, HIPAA, Modifiers, EPCR's and all forms of medical billing (direct, 3rd party, HMO's, private pay, no-fault, worker's comp, Medicare & Medicaid). Excellent organizational skills and the ability to multi-task in a fast-paced environment. Review and research data; use intuition and experience to complement data. Thorough knowledge of transport documentation (PCRs). Ability to follow up on outstanding insurance claims. Ability able to submit appeals and overpayment requests. Health Insurance Portability and Accountability Act (HIPAA) requirements and record retention compliance. Excellent written and verbal communications skills required Excellent documentation skills (promptness, accuracy, thoroughness, and legibility). Credit & Collections Procedures, Payment Plan/ Settlements. Customer Service/ Client relations.

Working knowledge of EMS systems/private ambulance and medical transportation systems preferred. Knowledge of Waystar/ Clearinghouse. Knowledge Microsoft Word, Microsoft Excel, and Microsoft Windows. Familiarity with medical terminology. Organizational and leadership abilities, detail oriented.

Work is performed under normal working conditions, as in a standard office environment. High level of sitting/working at a desk. Light physical effort (lift/carry up to 10 lbs.). Must be able to perform the essential duties of the position with or without reasonable accommodations.